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Video Details
Crown Lengthening in Comprehensive Esthetic Therapy: The Complete Surgical Video A to Z

Description:
In this complete surgical video, Dr. David Wong performs an esthetic crown lengthening procedure to address a "gummy smile" as part of comprehensive therapy and smile enhancement. Dr. Wong will outline the indications for crown lengthening surgery as opposed to orthognathic correction. The surgical video will demonstrate the complete crown lengthening surgery, including incision design, flap management and instrumentation. In addition, suturing and post-operative care will also be outlined in detail.

Date Added:
11/23/2016

Author(s):

David Wong, DDS David Wong, DDS
Dr. David Wong is a board-certified Periodontist in private practice in Tulsa, Oklahoma.

Dr. Wong received his undergraduate education and dental training at the Un...
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Online Videos / Surgery / Periodontic Surgery / Crown Lengthening in Comprehensive Esthetic Therapy: The Complete Surgical Video A to Z




Questions & Comments
Tamara Osina-Felinski - (9/19/2017 12:43 PM)

Great video! Thanks!

david wong - (3/2/2017 12:25 AM)

Hello Hani, thanks for watching the video. For this type of case, where the patient has no interproximal bone loss, it honestly does not matter what type of suture or suturing technique you use... Once you have interproximal bone loss present, I like to use vertical mattress sutures OR not even reflect the papilla at all (simply incise horizontally across the papilla like William Robbins out of the Kois Center teaches). I reserve apically positioned flaps for cases where there is inadequate keratinized/attached gingiva for a gingivectomy. I don't like split thickness flaps for this procedure because it 1) increases pain 2) increases bleeding and 3) increases swelling, 4) Increases risk of bruising. I only go as small a 5-0 sutures for this procedure because it is not so technique sensitive... to be honest, my reason for this is that I get frustrated when my needle holders can't grasp the suture :-). Hope that answers your questions!

Hani Fadel785 - (3/1/2017 5:34 PM)

Thanks for the very nice video and explanation David! My question is related to your choice of suturing technique. Apparently by using the sling suture you did not look for any apical repositioning of the flap. I know some periodontists advocate split thickness, periosteal anchorage and mattress suturing at the papillae for apical repositioning of the flap at the level of the CEJ. What are your thoughts about that and do you recommend any alternative suturing methods? Also would you go for smaller size sutures? Thanks again!

Benjamin Saidel - (1/23/2017 7:49 PM)

Thanks Dr. Wong

david wong - (1/23/2017 6:57 PM)

Hi Benjamin, No special LA techniques used here... just simple labial/buccal infiltration with 4 carpules 4% septocaine w/ 1:100,000 epi. 2 carpules 0.5% marcaine w/ 1:200,000 epi. I also directly infiltrate the papillae to minimize bleeding while the initial gingivectomy is performed.

Benjamin Saidel - (1/21/2017 12:30 PM)

Question 1 what LA techniques did you use and how much LA did you use?

aryeh gellman - (12/7/2016 2:14 PM)

thx alot !! great info and presentation aryeh

Arun Thomas616 - (12/6/2016 4:53 AM)

thanks david

Bajram Selimaj - (12/2/2016 8:08 AM)

Wonderfol presentation.

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