I'm told after a crown has to be re-done do to a gap in the margins between tooth and crown, that I need a gingivectomy. Would you ever need a gingivectomy in a normal circumstance, when getting a crown?
When Getting a Crown is There Ever a Need for a Gingivectomy?
Doctor Answers (10)
Laser Gingivectomy for a Crown procedure
Gingviectomy is a gum surgery that involves removing gum tissue around a tooth or teeth with the use of a scalpel and more recently with the use of diode lasers. When getting a crown the indications for a gingivectomy include:
1. Removal of infected or affected gum tissue
2. To contour the 'gum line' so that it is aesthetically pleasing (in relation to the adjacent teeth or to reduce a 'gummy-smile')
3. To increase the amount of tooth structure that is exposed, in-turn the crown will have more tooth to hold on to. This will increase the retention of the crown.
I hope this helps. Wish you all the best.
Gingivitis is not normal and a Gingivectomy is not the Answer
A gap between the gum and the crown can signal decay, gum recession or an ill fitting crown. A gingivectomy means you are getting rid of excess tissue. Reasons that you may need a gingivectomy include gum reshaping that may occur from gum disease, uneven gums and occasionally it is used to correct hyperplastic gum tissues that occur with some medications. Talk to a Periodontist to find out what you need-Good Luck
Most of the time a gingivectomy is not needed to do a new crown on a tooth. The reasons it is sometimes needed are: 1) due to a deeply decayed or broken tooth that is well under the gumline which would cause chronic irritation if it is not adjusted (usually this would require some bone recontouring also) or 2) for a cosmetic reasons depending on where the tooth is located. Have your dentist discuss his rationale for recommending the gingivectomy and get a second opinion if you are not comfortable.
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Need for Gingivectomy when getting a crown
I rarely do gingivectomies when doing crowns. The only reason to do a gingivectomy is if there is an overgrowth of gingiva in to an are where the tooth has broken down below the gum line. There should be a ferrule or margin of solid tooth structure of at least 2mm all the way around the perimeter of the prep. If there isn't then you need more than a gingivectomy reduction of osseous (bones tissue) as well. THere is something that is recognized as "the biologic width" THis principle means that the margin of a crown must end 2-3 mm from the height of the crest of the bone or there will be a condition of chronic irritation - meaning swollen, bleeding and sore. If a tooth is broken down to the level of bone then often it si better to just extract the tooth and have an implant
When is gingivectomy and/or crown lengthening needed
Almost always, when replacing an existing crown, the replacement crown is longer, larger and margins are placed below the gum due to recurrent decay, fracture,etc... So gingivectomy is almost always needed, but in different extents. And all it entails is removal of excess gum.
Crown Lengthening, however is removal of the BONE around the tooth that is being crowned. It is not as common s gingivectomy when replacing a crown. This procedure is needed if there is a lack of room for placement of the crown margins, or whenever the decay has gone down below the bone.
Some times when an old crown develops a space between it and the underlying tooth, gum tissue can become inflamed and grow into that spot. In order to create good access for a new crown this tissue may be removed by performing a gingivectomy procedure, which is simply removing tissue. I have found that the easiest and most effective way is by using a soft tissue laser.
When Getting a Crown is There Ever a Need for a Gingivectomy?
A gingivectomy means nothing more than "to remove some of the gum tissue". It often is necessary during dental crown treatments. When a tooth needs a crown, it is because it either has a large filling in it, it has broken or has a new cavity in it. In my practice I find that there is almost always some part of the problem that extends to the edge or even under the edge of the gum. Often times there is some gingivitis or even periodontal disease associated with this area.
In my practice I routinely use a dental laser to do a gingivectomy or to do highly localized laser gum cleaning of the problem area.
Every office is different. I would say many office do not do this routinely. In my opinion, the ones that do it, and do it well usually leave the gum in better condition, than not doing it.
In highly cosmetic or aesthetic areas, doing a gingivectomy also allows the cosmetic dentist to create as beautiful outline as possible. These are other elements that affect the beauty of the final result.
Is a Gingivectomy Needed When Receiving a Crown?
There are times when a gingivectomy is needed when having a dental crown performed. A gingivectomy is the removal of soft tssue for cosmetic or functional reasons. I routinely perform gingivectomies with a laser when doing crowns where the cavity is below the gumline. This will allow for a crown that is easier to keep clean allowing for healthy gum tissues around your crown. Hope this helps.
Does getting a crown warrent a gingivectomy?
Under most circumstances, a gingivectomy is not necessary when performing a crown prep procedure. A dentitst can perform this procedure if he wishes to balance the gum tissue with the adjacent teeth for cosmetic reasons. For functional reasons, if the gum tissue is impinging on the margin, a dentist may want to remove the tissue in order to get a perfect impression. I hope that helps! Good luck!
The need for a gingivectomy when getting a crown
Gingviectomy is minor gum surgery that involves the removal of a small amount of gum tissue around a tooth or teeth. A Gingivectomy often is done to correct a gummy smile or to remove a small amount of gum so a crown can be placed properly.If there is too much gum and not enough crown showing the balance of tooth vs gum line may not look esthetically pleasing.This can be be done with a soft tissue laser and there is no pain and recovery is immediate. I would find a dentist who uses a soft tissue laser in his practice and go that route rather than having an incision and waiting two weeks for healing. Good luck!