Crown Elongation in Montréal
If you have a tooth that has serious damage — be it a deep crack, a large chip, a large area of decay, or has been shortened by nightly grinding of your teeth — that tooth is in danger of needing extraction. It no longer has the strength to stand up to the forces of chewing and biting. That tooth needs a crown, the dental prosthetic that fits over the natural tooth, covering it all the way down to the gum line. A crown returns strength to an otherwise weakened tooth, and this enables you to keep your natural tooth in place rather than extracting it and replacing it with a dental implant.
But what if there isn’t enough remaining of your natural tooth to successfully place a crown on it? You need to lengthen or elongate the “crown” of the tooth. Crown elongation will remove gum tissue and sometimes bone to expose more of the tooth’s “crown,” the visible portion. Now the tooth has enough visible material to successfully hold the prosthetic crown.
What is crown elongation?
Crown elongation surgery, also called crown lengthening, involves making the tooth available to hold a crown. This surgery removes the extra gum tissue and bone needed to provide a better surface for the prosthetic crown to fit over and be cemented onto.
Who is a candidate for crown elongation?
If you have a tooth with serious damage, that tooth is in danger of needing to be extracted, and you’re a candidate for a crown. As mentioned above, it could be a deep crack, or it could be a second cavity in a tooth that already has a filling in it. Removing the decayed tooth matter won’t leave enough healthy mass for the tooth to survive on its own. It needs a crown.
If there isn’t enough visible tooth mass to adequately hold the crown, you’re a candidate not only for a crown, but for crown elongation to prepare the tooth before placing the crown.
Crowns can also be used for cosmetic purposes, such as covering a tooth that is oddly shaped and doesn’t fit in with your smile. Or if a tooth has deep interior staining from a reaction to tetracycline when you were young(tetracycline had the unfortunate side effect of staining teeth grey). Also, crowns provide the anchors for bridges, sitting atop the two healthy teeth on each side of a missing tooth. Even though these are all cosmetic uses, there needs to be enough visible tooth mass above the gum line to successfully place the crown over the tooth.
If any of these scenarios sound like your tooth situation, you need crown elongation to prepare the tooth for the crown.
How is crown lengthening done?
Dr. Slepchik typically performs these procedures with the patient using Dental Vibe along with the Wand. The goal varies between patients: in some cases, removing gum tissue will be all that is required, but in others, bone will also need to be removed.
Dr. Slepchik makes cuts that pull the gums away from the teeth. This exposes the roots of the teeth and the surrounding bone. With gummy smiles, usually simply removing gum tissue can be sufficient. But most of the time for restorative cases, Dr. Slepchik will need to remove some bone from around the roots of the teeth. When enough of the tooth has been exposed, the area is washed with sterile water and the gums are stitched back together.
For simply removing gum tissue, Dr. Slepchik may be able to use only his diode laser, which allows for an easier recovery.
How long will healing take after crown lengthening?
Crown lengthening patients return to our offices in 7-10 days, and we remove their stitches. We’ll need to see you again in 4-6 weeks for a follow-up. Your gums will need to heal for about three months before they are ready for the crown or other necessary treatment.
What are the risks involved with crown lengthening?
Your gums may not stop bleeding, at least not in the normal timeframe. Also, infection is always possible with dental procedures. Because more of the tooth root is exposed, and because this part of the tooth is not covered with enamel, patients can have increased sensitivity to hot and cold in these teeth. This passes with time, or when the crown is placed over the tooth
What will my recovery be like?
The full healing cycle, as mentioned above, is about three months. But that’s to prepare for the restoration. Otherwise, patients can return to normal activity as their gums heal. Strenuous activity only needs to be avoided for 2-3 days because the increased blood pressure to the face can cause more bleeding.
For pain, you may only need ibuprofen or Tylenol, but we will give you a prescription for pain medication. Using an ice pack for the first few hours after you return home will help with swelling. Follow 20 minutes on/20 minutes off schedule. After two days of this, you can switch to moist heat for comfort.
No hot foods for 24 hours, and no rinsing of your mouth. These can both extend your bleeding. If bleeding does continue, place a moistened tea bag on the spot and apply light pressure for 20-30 minutes.
Brush gently, only on the biting surfaces above where your dressings are. Elsewhere in your mouth you can brush and floss normally.
You’ll eat a soft diet until your gums heal, but you should also avoid acidic, spicy, sticky, or brittle foods. No nuts or small seeds. Drink plenty of fluids. Avoid alcohol until after your post-op appointment in 7-10 days.
How long after crown elongation can I get my crown placed?
For most patients, they need to wait three months for their gums to fully heal before Dr. Slepchik can place the crown on the tooth
What kind of anesthesia is used for crown elongation?
Dr. Slepchik performs these procedures with the patient under local anesthesia, usually in combination with oral sedation.