Podcast
Questions and Answers
What is the primary reason for performing crown lengthening?
What is the primary reason for performing crown lengthening?
- To expose subgingival caries (correct)
- To alleviate tooth sensitivity
- To improve aesthetics of the smile
- To enhance tooth color
Which of the following is NOT an indication for crown lengthening?
Which of the following is NOT an indication for crown lengthening?
- Short clinical crowns
- Presence of enamel caries (correct)
- Poor esthetic appearance due to gingival levels
- Restorative margins placed below the gum line
What is meant by biological width in restorative dentistry?
What is meant by biological width in restorative dentistry?
- The distance from the gingival margin to the alveolar crest
- The natural seal created around teeth (correct)
- The maximum height of the crown
- The total length of the tooth root
Which method is NOT used to evaluate a violation of biological width?
Which method is NOT used to evaluate a violation of biological width?
What condition indicates a violation of biological width?
What condition indicates a violation of biological width?
What is a contraindication for crown lengthening procedures?
What is a contraindication for crown lengthening procedures?
What is the average measurement of the junctional epithelium in biologic width?
What is the average measurement of the junctional epithelium in biologic width?
Which aesthetic concern is a reason for crown lengthening?
Which aesthetic concern is a reason for crown lengthening?
Which radiographic feature may suggest a violation of biological width?
Which radiographic feature may suggest a violation of biological width?
What does the biologic width violation indicate regarding periodontal health?
What does the biologic width violation indicate regarding periodontal health?
What is the primary purpose of the parallel profile radiographic technique?
What is the primary purpose of the parallel profile radiographic technique?
Why might crown margins be placed supragingivally during a crown lengthening procedure?
Why might crown margins be placed supragingivally during a crown lengthening procedure?
Which margin placement guideline applies when the sulcus probes more than 1.5mm?
Which margin placement guideline applies when the sulcus probes more than 1.5mm?
Which type of margin is associated with the greatest biologic risk?
Which type of margin is associated with the greatest biologic risk?
Which statement about equigingival margins is accurate based on current understanding?
Which statement about equigingival margins is accurate based on current understanding?
What is one of the primary indications for crown lengthening?
What is one of the primary indications for crown lengthening?
What is a contraindication for performing crown lengthening?
What is a contraindication for performing crown lengthening?
How can probing under local anesthesia assist in identifying biologic width?
How can probing under local anesthesia assist in identifying biologic width?
What is a common location where biologic width violation is likely to be found?
What is a common location where biologic width violation is likely to be found?
Which of the following is true regarding the supragingival margin placement?
Which of the following is true regarding the supragingival margin placement?
What is the primary definition of crown lengthening?
What is the primary definition of crown lengthening?
Which of the following is NOT an indication for performing crown lengthening?
Which of the following is NOT an indication for performing crown lengthening?
Which method is used in surgical crown lengthening?
Which method is used in surgical crown lengthening?
What is one reason why crown lengthening might be contraindicated?
What is one reason why crown lengthening might be contraindicated?
Which of the following is a method of crown lengthening?
Which of the following is a method of crown lengthening?
What procedure is indicated for gingival overgrowth?
What procedure is indicated for gingival overgrowth?
Which statement accurately describes a biological width concern?
Which statement accurately describes a biological width concern?
Which procedure improves inadequate tooth structure for restoration?
Which procedure improves inadequate tooth structure for restoration?
What is the primary purpose of crown lengthening?
What is the primary purpose of crown lengthening?
What is a common goal of esthetic periodontal corrective procedures?
What is a common goal of esthetic periodontal corrective procedures?
When might a surgical approach to crown lengthening be preferred?
When might a surgical approach to crown lengthening be preferred?
Which method is NOT a recognized technique for surgical crown lengthening?
Which method is NOT a recognized technique for surgical crown lengthening?
In what situation should gingivectomy be performed for crown lengthening?
In what situation should gingivectomy be performed for crown lengthening?
What is the contraindicator for performing crown lengthening using flap + osseous resection method?
What is the contraindicator for performing crown lengthening using flap + osseous resection method?
Which statement about ferrule length is correct?
Which statement about ferrule length is correct?
What defines the apical one-third of a tooth preparation in relation to restoration?
What defines the apical one-third of a tooth preparation in relation to restoration?
What is one indicator for selecting orthodontic crown lengthening?
What is one indicator for selecting orthodontic crown lengthening?
Which of the following is a benefit of using a ferrule?
Which of the following is a benefit of using a ferrule?
What condition must be present for flap + osseous resection to be appropriate for crown lengthening?
What condition must be present for flap + osseous resection to be appropriate for crown lengthening?
Which factor is NOT involved in assessing the need for crown lengthening?
Which factor is NOT involved in assessing the need for crown lengthening?
A subgingival margin placement has the least impact on the periodontium.
A subgingival margin placement has the least impact on the periodontium.
A margin should be placed 0.5mm below the gingival crest if the sulcus probes 2.0mm.
A margin should be placed 0.5mm below the gingival crest if the sulcus probes 2.0mm.
The parallel profile radiographic technique is a simple and reproducible method to measure biologic width.
The parallel profile radiographic technique is a simple and reproducible method to measure biologic width.
Equigingival margins are known to retain less plaque than supragingival margins.
Equigingival margins are known to retain less plaque than supragingival margins.
A biologic width violation is confirmed when the distance from the bone level to the depth of the sulcus is greater than 2mm.
A biologic width violation is confirmed when the distance from the bone level to the depth of the sulcus is greater than 2mm.
Crown lengthening is primarily indicated for improving inadequate tooth structure for restoration.
Crown lengthening is primarily indicated for improving inadequate tooth structure for restoration.
Radiographic evaluation can fully diagnose interproximal violations of biologic width.
Radiographic evaluation can fully diagnose interproximal violations of biologic width.
Surgical crown lengthening is contraindicated if the tooth structure is adequate for restoration.
Surgical crown lengthening is contraindicated if the tooth structure is adequate for restoration.
The depth of the sulcus directly affects where the crown margin should be placed in relation to the gingival crest.
The depth of the sulcus directly affects where the crown margin should be placed in relation to the gingival crest.
Gingivectomy is a procedure indicated for shallow sulcus depths of 1.5mm or less.
Gingivectomy is a procedure indicated for shallow sulcus depths of 1.5mm or less.
Crown lengthening is primarily performed to address functional concerns rather than esthetic ones.
Crown lengthening is primarily performed to address functional concerns rather than esthetic ones.
One indication for crown lengthening is the presence of excessive gingival display.
One indication for crown lengthening is the presence of excessive gingival display.
The biological width does not play a role in determining whether crown lengthening is needed.
The biological width does not play a role in determining whether crown lengthening is needed.
Crown margins are typically placed more supragingivally to assist with impression accuracy.
Crown margins are typically placed more supragingivally to assist with impression accuracy.
Short clinical crowns can lead to difficulties in retention and esthetic concerns, necessitating crown lengthening.
Short clinical crowns can lead to difficulties in retention and esthetic concerns, necessitating crown lengthening.
Biological width is solely about the depth of the histologic sulcus.
Biological width is solely about the depth of the histologic sulcus.
Chronic progressive gingival inflammation is a sign of biological width violation.
Chronic progressive gingival inflammation is a sign of biological width violation.
Exposure of subgingival caries is an absolutely contraindicated reason for performing crown lengthening.
Exposure of subgingival caries is an absolutely contraindicated reason for performing crown lengthening.
Crown lengthening procedures only involve surgical methods.
Crown lengthening procedures only involve surgical methods.
Delayed passive eruption can lead to the need for crown lengthening procedures.
Delayed passive eruption can lead to the need for crown lengthening procedures.
Crown lengthening is performed only for functional concerns and not for esthetic reasons.
Crown lengthening is performed only for functional concerns and not for esthetic reasons.
Gingivectomy is one of the methods used in crown lengthening procedures.
Gingivectomy is one of the methods used in crown lengthening procedures.
Crown lengthening may be indicated if there is inadequate tooth structure for a restoration.
Crown lengthening may be indicated if there is inadequate tooth structure for a restoration.
A contraindication for crown lengthening procedures could be the presence of significant gingival recession.
A contraindication for crown lengthening procedures could be the presence of significant gingival recession.
The definition of crown lengthening involves increasing the amount of tooth exposed supragingivally.
The definition of crown lengthening involves increasing the amount of tooth exposed supragingivally.
Forced eruption with fiberotomy is not considered a surgical method for crown lengthening.
Forced eruption with fiberotomy is not considered a surgical method for crown lengthening.
Apically positioned flaps (APF) can be combined with osseous resection in crown lengthening procedures.
Apically positioned flaps (APF) can be combined with osseous resection in crown lengthening procedures.
Aesthetic periodontal corrective procedures do not include interventions for gingival overgrowth.
Aesthetic periodontal corrective procedures do not include interventions for gingival overgrowth.
Surgical crown lengthening is only recommended when there are no alternative orthodontic techniques available.
Surgical crown lengthening is only recommended when there are no alternative orthodontic techniques available.
Electrosurgery and laser techniques are not applicable to esthetic contouring in periodontal treatments.
Electrosurgery and laser techniques are not applicable to esthetic contouring in periodontal treatments.
Gingivectomy is an appropriate method for crown lengthening when there is less than 2 mm of Keratinized gingiva.
Gingivectomy is an appropriate method for crown lengthening when there is less than 2 mm of Keratinized gingiva.
Crown lengthening can be performed using both surgical and orthodontic methods.
Crown lengthening can be performed using both surgical and orthodontic methods.
The apical one-third of a tooth preparation does not contribute to the retention of a restoration.
The apical one-third of a tooth preparation does not contribute to the retention of a restoration.
A contraindication for crown lengthening can include insufficient Keratinized gingiva.
A contraindication for crown lengthening can include insufficient Keratinized gingiva.
Flap + Osseous resection is suitable for crown lengthening when there is more than 2 mm from the CEJ to the alveolar bone crest.
Flap + Osseous resection is suitable for crown lengthening when there is more than 2 mm from the CEJ to the alveolar bone crest.
Crown lengthening is defined as a procedure to increase the height of the crown on a tooth by removing keratinized tissue.
Crown lengthening is defined as a procedure to increase the height of the crown on a tooth by removing keratinized tissue.
Orthodontic crown lengthening is the only method that can be used for aesthetic reasons.
Orthodontic crown lengthening is the only method that can be used for aesthetic reasons.
The distance from the cemento-enamel junction (CEJ) to the alveolar bone crest must be at least 2 mm for gingivectomy to be appropriate.
The distance from the cemento-enamel junction (CEJ) to the alveolar bone crest must be at least 2 mm for gingivectomy to be appropriate.
The greatest resistance to dislodgement of the restoration is found at the incisal edge of the preparation.
The greatest resistance to dislodgement of the restoration is found at the incisal edge of the preparation.
Crown lengthening can be performed effectively without any pre-existing conditions concerning Keratinized gingiva.
Crown lengthening can be performed effectively without any pre-existing conditions concerning Keratinized gingiva.
Study Notes
Biological Width
- Defined as the distance formed by junctional epithelium and connective tissue attachment on tooth roots.
- Typical mean depth of histologic sulcus is approximately 0.69 mm.
- Average junctional epithelium depth measures around 0.97 mm, and supraalveolar connective tissue attachment is about 1.07 mm.
- Total average biologic width is approximately 2.04 mm.
Biologic Width Violation
- Identified through probing under local anesthesia; a measurement of biologic width is obtained by subtracting sulcus depth from the bone level.
- A distance of less than 2 mm at any probing site confirms a biologic width violation.
- Radiographic evaluation, particularly through bitewing films, can potentially uncover interproximal violations, though limitations exist.
Margin Placement Guidelines
- For sulcus depth ≤ 1.5 mm, place margin 0.5 mm below the gingival crest.
- For sulcus depth > 1.5 mm, place margin 1-2 mm below the crest depending on specific readings.
- If probing indicates > 2.0 mm, perform a gingivectomy and establish a 1.5 mm sulcus before placing the margin.
Types of Margins
- Supragingival Margin: Least destructive to periodontium.
- Equigingival Margin: Previously thought to retain more plaque but is now regarded similarly to supragingival in periodontal tolerance.
- Subgingival Margin: Associated with greatest biologic risk and challenging for hygiene maintenance.
Crown Lengthening
- Procedure used to increase exposed tooth structure above the gum line, crucial for retention when there are short clinical crowns or subgingival margins.
- Indications include inadequate retention due to extensive caries, unequal gingival levels, and cosmetic concerns from delayed passive eruption.
- Methods of crown lengthening vary, including gingivectomy, flap surgery with osseous resection, and apically positioned flaps.
Clinical Considerations
- Signs of violation include chronic gingival inflammation, bleeding on probing, localized hyperplasia with minimal bone loss, and gingival recession.
- Clinical crown is the visible part of the tooth above the alveolar crest.
- A proper ferrule length around the tooth is critical for prosthetic success, minimizing occlusal stress on the periodontal ligament.
Esthetic Procedures
- Surgical crown lengthening and forced eruption are employed for inadequate tooth structure.
- Grafting techniques, such as free gingival grafts or guided tissue regeneration, address gum recession and overgrowth.
- Electrosurgery and lasers are also used for contouring and esthetic enhancements.
Key Figures
- Ferrule length must ideally reach 1-2 mm above the preparation's apical third to optimize restoration retention.
Biological Width
- Defined as the distance formed by junctional epithelium and connective tissue attachment on tooth roots.
- Typical mean depth of histologic sulcus is approximately 0.69 mm.
- Average junctional epithelium depth measures around 0.97 mm, and supraalveolar connective tissue attachment is about 1.07 mm.
- Total average biologic width is approximately 2.04 mm.
Biologic Width Violation
- Identified through probing under local anesthesia; a measurement of biologic width is obtained by subtracting sulcus depth from the bone level.
- A distance of less than 2 mm at any probing site confirms a biologic width violation.
- Radiographic evaluation, particularly through bitewing films, can potentially uncover interproximal violations, though limitations exist.
Margin Placement Guidelines
- For sulcus depth ≤ 1.5 mm, place margin 0.5 mm below the gingival crest.
- For sulcus depth > 1.5 mm, place margin 1-2 mm below the crest depending on specific readings.
- If probing indicates > 2.0 mm, perform a gingivectomy and establish a 1.5 mm sulcus before placing the margin.
Types of Margins
- Supragingival Margin: Least destructive to periodontium.
- Equigingival Margin: Previously thought to retain more plaque but is now regarded similarly to supragingival in periodontal tolerance.
- Subgingival Margin: Associated with greatest biologic risk and challenging for hygiene maintenance.
Crown Lengthening
- Procedure used to increase exposed tooth structure above the gum line, crucial for retention when there are short clinical crowns or subgingival margins.
- Indications include inadequate retention due to extensive caries, unequal gingival levels, and cosmetic concerns from delayed passive eruption.
- Methods of crown lengthening vary, including gingivectomy, flap surgery with osseous resection, and apically positioned flaps.
Clinical Considerations
- Signs of violation include chronic gingival inflammation, bleeding on probing, localized hyperplasia with minimal bone loss, and gingival recession.
- Clinical crown is the visible part of the tooth above the alveolar crest.
- A proper ferrule length around the tooth is critical for prosthetic success, minimizing occlusal stress on the periodontal ligament.
Esthetic Procedures
- Surgical crown lengthening and forced eruption are employed for inadequate tooth structure.
- Grafting techniques, such as free gingival grafts or guided tissue regeneration, address gum recession and overgrowth.
- Electrosurgery and lasers are also used for contouring and esthetic enhancements.
Key Figures
- Ferrule length must ideally reach 1-2 mm above the preparation's apical third to optimize restoration retention.
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Description
Explore the concept of biologic width in dental anatomy and the implications of its violation. This quiz covers probing techniques, radiographic evaluations, and the clinical significance of maintaining biologic width. Test your understanding of these crucial dental principles.
