A resective periodontal surgical procedure requiring recountouring of the gingiva and usually the supporting bone

 

General indications include

            Subgingival caries

            Perforations or fractures in the coronal third of the root

            Inadequate retention for a restoration due to a short clinical crown

 

Anterior indications include

           Aesthetics

                     Altered passive eruption

                     Excessive gingival display

                      Attachment loss due to periodontal disease

 

Limiting factors include

           Patient health

            Anatomical considerations

            Aesthetics

            Cost

 

Limiting factors include

        Root dimensions

        Length

        Width

        Anteriorly soft tissue support

 

Limiting factors include

            Prognoses of adjacent teeth following surgery

            Furcations

 

Alternatives may include

            Extraction

            Orthodontic extrusion with or without crown lengthening

            Compromise on aesthetics

            Orthodontics to intrude with or without crown lengthening

      

Surgery involves gingival contouring to desired position followed by complimentary osseous recontouring to establish biologic width at new level.

 

 

 

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