Gingival Margin Stability Following Esthetic Crown Lengthening Utilizing a Double Periodontal Surgical Guide

Gingival Margin Stability Following Esthetic Crown Lengthening by Electrocautery, Diode Laser, or a Scalpel Blade Utilizing a Double Periodontal Surgical Guide. (A Prospective Randomized Clinical Trial)

In patients with excessive gingival display, esthetic crown lengthening procedure by means of scalpel, diode laser or electro-surgery could result in the same gingival marginal stability at 3 and 6 months follow up.

Scalpel crown lengthening has been recommended as the gold standard for treating excessive gingiva. Two other established tools used for gingivectomy procedures are electrosurgery and lasers. Laser crown lengthening may have the advantages of less bleeding during the procedure, faster healing, and less pain following the procedure. Electrosurgery which involves the application of a high- frequency electric current to the gingiva has been shown to produce minimal bleeding, ease and speed of cutting and reduced postoperative pain. The null hypothesis that the three techniques for aesthetic crown lengthening (ACLP) would show equivalent gingival margin stability at 3 and 6 months follow up.

Inclusion Criteria:

• Altered passive eruption as presence of quadratic anterior teeth [crown width/length ratio

  • 0.85 ].

• Gingival margin located coronal to the tooth cervical convexity and >2 mm of gingival band display during maximum smile.

• Patients with treated periodontal disease (i.e., stage I of periodontitis);

Exclusion Criteria:

• Patients with systemic contraindications for oral surgery as uncontrolled diabetes.
• patients on drug therapy related with drug-associated gingival enlargement.
• Areas in which the remaining amount of keratinized gingiva after the submarginal incision is less than 3 mm.
• Previous surgical treatment in the same area.