This article presents an innovative approach to crown lengthening that offers predictable esthetics and harmonious bone and gingival contours. Following fabrication of the diagnostic wax-up, a provisional fixed prosthesis is constructed. At the time of provisional insertion, the tooth, marginal gingiva, and crestal bone are prepared with rotary instruments using a prosthetic template as a guide. This procedure is known as guided soft and hard tissue preparation. The provisional is then inserted, thus invading the biologic width. Within no more than 2 weeks, bone resective surgery is performed to recreate normal biologic width. A well-defined preparation margin acts as a guide during the osteoplasty procedure, which is used to reestablish the correct distance between the crown margin and crestal bone. A total of 10 patients in need of crown lengthening have been treated with this procedure, and 1-to 7-year follow-ups have shown good esthetic results and stable tissue levels.
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