Crown Lengthening

A smile significantly influences perceptions of attractiveness, confidence, intelligence, and trustworthiness. One key factor affecting smile aesthetics is excessive gingival display, commonly referred to as a "gummy smile," often caused by altered passive eruption (APE) or other dental etiologies such as tooth malformations or subgingival fractures. Crown Lengthening Surgery (CLS) is a widely adopted periodontal procedure aimed at exposing more of the tooth structure for functional or esthetic purposes. First introduced by D.W. Cohen in 1962, CLS involves repositioning the gingival margin and often includes soft and/or hard tissue removal. Indications for CLS can be broadly categorized into prosthetic, esthetic, and restorative needs. Techniques for crown lengthening have evolved from conventional apically positioned flaps and osseous resection to modern approaches incorporating electrocautery, piezosurgery, lasers, cryosurgery, and chemosurgery. These methods offer varying degrees of precision, hemostasis, and patient comfort. Recent advances include the use of CAD-CAM technology for enhanced surgical accuracy through customized digital guides.