ANSWERS

How does crown lengthening affect lab fabrication?

Crown lengthening exposes more tooth structure and shifts the margin apically, which changes how the lab designs the restoration. Labs need updated impressions or scans taken 6 to 8 weeks after surgery once tissue stabilizes. Margin placement, emergence profile, and contact points must be redesigned.

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Why it works this way

Why the surgery changes the lab's job

Crown lengthening removes 2 to 4 mm of gingival tissue and often osseous structure to expose sound tooth for ferrule, esthetics, or biologic width restoration. The 2018 AAP classification confirms biologic width averages 2.04 mm (Gargiulo's foundational measurement, still cited). When the margin moves apically by that distance, every line the lab uses to design the restoration moves with it: the finish line, the emergence profile, the interproximal contacts, and the cervical contour. A crown designed off the pre-op scan will sit on tissue that no longer exists.

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How long should I wait after crown lengthening before taking the final impression?

6 to 8 weeks for posterior teeth, 12 weeks for anterior esthetic cases. Tissue continues to mature for up to 6 months, but the practical stability window for impression-taking starts at 6 weeks for posterior cases. Anterior cases need the longer wait because gingival zenith position drives the esthetic outcome, and early scans capture tissue that will continue to migrate. Sending earlier scans is the single most common cause of remakes on crown-lengthened cases.

Does the lab need to know if osseous recontouring was performed?

Yes. Osseous (bone) recontouring changes biologic width considerations and affects how aggressively the lab can place the margin subgingivally. Soft-tissue-only crown lengthening rebounds differently than cases involving osseous reduction. Note osseous recontouring on the Rx along with the surgery date and ferrule height achieved. The technician designing the restoration uses this to set finish line depth and emergence profile correctly the first time.

Can I send a pre-surgical scan and have the lab design around the planned margin?

No. Even with a planned margin annotated, the actual post-healing tissue position varies from the surgical plan by 0.5 to 1.5 mm in most cases. Designing off a predicted margin produces a restoration that fits the prediction, not the patient. Wait for the post-healing scan. The 6 to 8 week delay costs less chair time than the remake appointment that follows a mis-fit crown delivered too early.

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