A BIOMETRIC APPROACH TO AESTHETIC CROWN LENGTHENING

therapy also encompasses aesthetic treatment where needs are frequently associated with changes in tooth size, shape, proportion, and balance that can negatively affect smile appearance.1
There exists a synergy between periodontics and restorative dentistry, where the disciplines are interdependent. In aesthetic dentistry where development of the proper tooth size, form, and color of restorations are critical to clinical success, often the periodontal component is considerable and must be addressed for a predictable aesthetic outcome. The need to establish the correct tooth size and thus individual tooth proportion drives the periodontal component of aesthetic restorative dentistry. One specific area of concern is excessively short teeth,2 where the lack of tooth display and excessive gingival display require clinical crown lengthening that can present a clinical dilemma for the aesthetic-oriented periodontist.
There are a myriad of techniques that have evolved over several decades to treat this situation. Techniques that simplify as well as enhance the quality of treatment can provide substantial benefit to both patients and treating practitioners alike. This article describes an innovative approach to periodontal aesthetic crown lengthening utilizing measurement gauges specifically designed for a predictable surgical outcome, thus setting a new standard of diagnosis and treatment within the aesthetic zone. Midfacial surgical crown lengthening has traditionally been performed to establish a healthy biologic dimension of the dentogingival complex (DGC) as an adjunct to aesthetic restorative procedures. While considerable variation in the magnitude or length of this complex has been reported, the mean sulcus depth was 0.69 mm, epithelial attachment was 0.97 mm, and the connective tissue was 1.07 mm.3 Therefore, the total length of the DGC was 2.73 mm. Based on these dimensions, several authors have suggested that 3 mm of supracrestal tooth structure be obtained during surgical crown lengthening.4,5 Other authors have suggested that supracrestal tooth structure ranges from 3.5 mm to 5.25 mm, depending on the placement of the restorative mar in.6,7 It is important, therefore, to establish a consistent measurement