Minimally invasive surgical techniques in clinical crown lengthening: A systematic review




Periodontics; Periodontal Attachment Loss; Surgery Oral.


The surgical procedure for the clinical crown lengthening, aims for an aesthetic or functional form to compensate for the reabsorption of the alveolar bone tissue caused by the invasion of the biological space. The conditions that must be taken into account during surgical planning are related to an excessive gingival exposure, altered passive eruption and lack of height of the dental element for restorative purposes. The objective of this systematic review was to evaluate in the scientific literature the minimally invasive surgical techniques used to clinical crown lengthening. A systematic review of the literature was performed using the databases, Science Direct, Embase, Cochrane Collaboration Library, and PubMed/MEDLINE. The search strategy provided a total of 157 studies. After selection, five articles met all the inclusion criteria and were included in this systematic review. Studies have shown that conventional surgical techniques for clinical crown lengthening are presented as an effective approach that promotes good aesthetic and functional results. However, they have some limitations. After evaluating the minimally invasive surgical techniques included in this systematic review, it was possible to infer that they presented satisfactory results in the soft and hard tissue contouring, with no complications and dissatisfaction being observed by the patients. 

Author Biographies

Alick Brianne Ribeiro Silva, Tiradentes University

Graduate in Dentistry from the University of Tiradentes

Herbert Alves, Tiradentes University

Graduate in Dentistry from the University of Tiradentes

Thiago de Santana Santos, Maxillofacial Education, Sergipe, Brazil.

Pós-Doutorado em Odontologia (UFS) PhD em Odontologia na área de concentração de Cirurgia e Traumatologia Buco-Maxilo-Facial (FORP/USP), Mestre em Odontologia na área de concentração de Cirurgia e Traumatologia Buco-Maxilo-Facial (FOP/UPE), Ex-residente de Cirurgia e Traumatologia Buco-Maxilo-Facial (Hospital Universitário Oswaldo Cruz), Especialista em Cirurgia e Traumatologia Buco-Maxilo-Facial (Colégio Brasileiro CTBMF/CFO), Especialista em Implantodontia (ABO-PE/UVA), Especialista em Odontologia Legal (FORP/USP).

Isabela de Avelar Brandão Macedo, Tiradentes University

Graduada em Odontologia pela UNIT-SE (2002). Doutora em Ciências Odontológicas com área de concentração em Clinicas Odontológicas. Mestrado em Saúde e Ambiente. Pos graduanda em Políticas de Saúde Informadas por Evidências (Sírio Libanes). Especialidade em Odontologia Legal, Odontologia do Trabalho, Prótese Dentária e Ortodontia. Atualmente Docente da Universidade Tiradentes - Aracaju (SE) no curso de Medicina (Tutoria em PBL - Módulo de Nascimento, Crescimento e Desenvolvimento; Percepção, Consciência e Emoção; Processo de Envelhecimento) e no curso de Odontologia nas disciplinas de Reabilitação Oral Protética I e na disciplina de Práticas de Odontologia II (com conteúdo direcionado para Saúde Coletiva). 


Chen, C. K., Wu, Y. T., Chang, N. J., & Lan, W. H. (2017). Er:YAG Laser for Surgical Crown Lengthening: A 6-Month Clinical Study. The International Journal of Periodontics & Restorative Dentistry, 37(2), e149-e153.

Deeb, J. G., Bencharit, S., Dalal, N., Abdulmajeed, A., & Grzech-Leśniak, K. (2019). Using Er:YAG laser to remove lithium disilicate crowns from zirconia implant abutments: An in vitro study. PLoS One, 14(11), e0223924.

Ebersole, J. L., Dawson, D. R., Morford, L. A., Peyyala, R., Miller, C. S., & Gonzaléz, O. A. (2013). Periodontal disease immunology:‘double indemnity’in protecting the host. Periodontology 2000, 62(1), 163-202.

Elavarasu, S., Naveen, D., & Thangavelu, A. (2012). Lasers in periodontics. Journal of Pharmacy and Bioallied Sciences, 4(2), S260–S263.

Ganji, K. K., Patil, V. A., & John, J. A. (2012). Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure. International Journal of Dentistry, 1(1), 479241.

Gaspirc, B., & Skaleric, U. (2007). Clinical evaluation of periodontal surgical treatment with an Er:YAG laser: 5-year results. Journal of Periodontology, 78(10), 1864-1871.

Kalaivani, S., Manohar, J., Shakunthala, S., Sujatha, S. A., Rajasekaran, B., & Karthikeyan, S. (2015). Crown lengthening procedure in the management of amelogenesis imperfecta.

Journal of Pharmacy and Bioallied Sciences, 7(2), S769–S772.

Koppolu, P., Kalakonda, B., Mishra, A., Lingam, A. S., Elkhatat, E., Ibrahim, A. A., & Abdulaziz, A. A. (2017). Smile Correction Using an Esthetic Crown Lengthening with Either Diode Laser or Scalpel–A Comparative Clinical Patient Perspective Study. Journal of Advances in Medicine and Medical Research, 1(1), 1-9.

Lavu, V., Arumugam, C., Venkatesan, N., Balaji, S. K., & Valandhan G. (2019). A Present Day Approach to Crown Lengthening – Piezosurgery. Cureus Journal of Medical Science, 11(11), e6241.

Mohan, K. P., Ravindra, R. N., Roopa, D., & Kishore, K. K. (2013). Atraumatic surgical extrusion using periotome in esthetic zone: A case series. Journal of Conservative Dentistry, 16(2), 175-179.

Moher, D., Liberati, A., Tetzlaff, J, & Altman, D. G. PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. Annals of Internal Medicine, 151(1), 264–269.

Moher, D., Schulz, K. F., & Altman, D. G. (2001). The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Annals of internal medicine, 134(1), 657-662.

Nethravathy, R., Vinoth, S. K., & Thomas, A. V. (2013). Three different surgical techniques of crown lengthening: A comparative study. Journal of pharmacy & bioallied sciences, 5(1), S14.

Paolantoni, G., Marenzi, G., Mignogna, J., Wang, H. L., Blasi, A., & Sammartino, G. (2016). Comparison of three different crown-lengthening procedures in the maxillary anterior esthetic regions.Quintessence International, 47(5), 407-416.

Patil, S. A., Kulkarni, S., Thakur, S., & Naik, B. (2016). Crown lengthening procedure following intentional endodontic therapy for correction of supra-erupted posterior teeth: Case series with long-term follow-up. Journal of Indian Society of Periodontology, 20(1), 103-108.

Ribeiro, F. V., Hirata, D. Y., Reis, A. F., Santos, V. R., Miranda, T. S., Faveri, M., & Duarte, P. M. (2014). Open‐flap versus flapless esthetic crown lengthening: 12‐month clinical outcomes of a randomized controlled clinical trial. Journal of periodontology, 85(4), 536-544.

Ryder, M. I., Couch, E. T., & Chaffee, B. W. (2018). Personalized periodontal treatment for the tobacco- and alcohol-using patient. Periodontology 2000, 78(1), 30-46.

Shobha, K. S., Seshan, H., Mani, R., & Kranti, K. (2010). Clinical evaluation of the biological width following surgical crown-lengthening procedure: A prospective study. Journal of Indian Society of Periodontology, 14(3), 160-167.

Tomar, N., Bansal, T., Bhandari, M., & Sharma, A. (2013). The perio-esthetic-restorative approach for anterior rehabilitation. Journal of Indian Society of Periodontology, 17(4), 535–538.




How to Cite

SILVA, A. B. R. .; ALVES, H. .; LAZARINO, V. L. .; NASCIMENTO, Y. M. L. do .; CASTELLO , L. F. M. .; COSTA, A. M. C. .; OLIVEIRA, T. T. C. de .; PINGARILHO, L. .; SANTOS, T. de S. .; MACEDO, I. de A. B. . Minimally invasive surgical techniques in clinical crown lengthening: A systematic review. Research, Society and Development, [S. l.], v. 9, n. 10, p. e579108256, 2020. DOI: 10.33448/rsd-v9i10.8256. Disponível em: Acesso em: 8 aug. 2022.



Health Sciences