Guided Soft and Hard Tissue Preparation: A Novel Technique for Crown Lengthening

Abstract

This article presents an innovative approach to crown lengthening that offers predictable esthetics and harmonious bone and gingival contours. Following fabrication of the diagnostic wax-up, a provisional fixed prosthesis is constructed. At the time of provisional insertion, the tooth, marginal gingiva, and crestal bone are prepared with rotary instruments using a pr osthetic template as a guide. This procedure is known as guided soft and hard tissue preparation. The provisional is then inserted, thus invading the biologic width. Within no more than 2 weeks, bone resective surgery is performed to recreate normal biologic width. A well-defined preparation margin acts as a guide during the osteoplasty procedure, which is used to reestablish the correct distance between the crown margin and crestal bone. A total of 10 patients in need of crown lengthening have been treated with this procedur e, and 1- to 7-year follow-ups have shown good esthetic results and stable tissue levels. Am J Esthet Dent 2013;3:24–37. doi: 10.11607/ajed.0049