Efficacy of crown lengthening for restoration of maxillary anterior tooth defects.

Objective: The appearance of the gingival tissue around the teeth is essential in the aesthetics of the anterior maxillary region of the oral cavity. Abnormalities in symmetry and contour can significantly compromise the appearance of the natural or restored dentition, so the outcome is highly relevant to treatment choice. This study evaluated the efficacy of crown lengthening for restoration of maxillary anterior tooth defects.

Methods: A total of 80 patients (87 affected teeth) diagnosed with maxillary anterior tooth loss in Ganzhou People's Hospital between May 2020 and August 2021 were retrospectively enrolled and divided into an experimental group or a reference group according to different treatment methods, with 40 cases in each group. The reference group received a post and core procedure, while the experimental group received crown lengthening plus a post and core procedure. Outcome measures included clinical efficacy, gingival periodontal-related indices, and dental aesthetics indices.

Results: Crown lengthening plus post and core procedure was associated with a significantly higher clinical efficacy (95.65%) versus post and core procedure alone (78.05%) (P<0.05). Postoperatively, the levels of probing depth (PD), plaque index (PLI), bleeding index (BI), and gingival index (GI) were lower in patients of the experimental group than those in the reference group (all P<0.05). Crown lengthening plus post and core procedure resulted in more Kay class I and II patients and fewer Kay class III and IV versus the post and core procedure alone (P<0.05). The position of gingival margin (PGM) and gingival recession (GR) of patients in the experimental group were higher than those in the reference group after operation (P<0.05). Logistic regression analysis showed that the morphology of broken ends, plaque control, hygiene habits, and smoking were influencing factors for maxillary anterior tooth defects (all P<0.05). Patients were more satisfied (97.50%) in the experimental group than those in the reference group (80.00%) (P<0.05).

Conclusion: Crown lengthening improves the periodontal condition of patients with maxillary anterior tooth loss, reduces gingival sulcus bleeding, and improves dental aesthetics and patient satisfaction. Further clinical studies are required prior to clinical promotion.