(TC01) Site-Specific Laser-Assisted Crown Lengthening

Teeth that require endodontic intervention are often structurally compromised due to conditions such as caries, trauma, or root resorption. Assessment of the restorability of teeth prior to endodontic treatment must remain a prerequisite to treatment, but the process by which dentists perform such an assessment is subject to considerable variation. The restoration of endodontically treated teeth might be compromised in cases with an inadequate height of the remaining coronal walls. This clinical scenario could result in a loss of the ferrule, which may significantly jeopardize the structural integrity and survivability of the tooth. Traditionally, in cases with insufficient ferrule, surgical crown lengthening or orthodontic extrusion are employed, but these treatment modalities may not be an option for patients with financial limitations. Then, this patient’s desire to retain their natural dentition places the dentist in a challenging position of managing a difficult, compromised clinical picture. Presented is another treatment option to postpone extraction and build up the restoratively challenged tooth prior to endodontic treatment: “site-specific laser-assisted crown lengthening”. Using an erbium laser, the soft tissue and crestal bone in the involved area is ablated thereby establishing a sound margin to be restored. Adequate hemostasis is routinely achieved by using an erbium laser with a wavelength of 2780 nm. This quick, simple procedure allows for predictable placement of a deep margin in a dry field and the retention of the natural, albeit guarded, tooth.