Long‐term survival of structurally compromised tooth preserved with crown lengthening procedure and restorative treatment: A pilot retrospective analysis

Abstract

Aim Since there is limited study to assist in an evidenced‐based decision whether to extract or preserve a structurally compromised tooth, the aim of this retrospective study was to investigate the long‐term survival rate of tooth preservation after crown lengthening procedure (CLP) and restorative treatments. Methods Electronic and paper chart of patients received CLP in our graduate clinic from 1990 to 2015 were reviewed. Statistical analysis was done using Cox regression analysis and Kaplan–Meier estimator. Results A total of 766 coded charts were initially collected. Four hundred and fourteen cases were included in the final analysis. The Kaplan–Meier estimate shows a cumulative survival rate of 88.3% in 5 years, 78.4% in 10 years and 68.1% in 15 years. In terms of reasons for failure, restorative problem such as recurrent decays was the main issue (35.2%), followed by fracture (29.6%), endodontic complications (23.9%) and periodontal breakdown (11.3%). Conclusions Within the limitation of this study, structurally compromised teeth have a reasonable long‐term survival rate close to 80% after 10 years in a teaching institute. Patients with high fracture or caries risk may pose a higher chance of failure. Objective information should be presented to the patient to arrive at an evidence‐based decision.

Success rate of fractured teeth receiving modified crown lengthening surgery and restorations

“…Moghaddam et al [ 8 ] reported survival rate ranging from 83.1 to 98.3% from 1 to 10 years for teeth treated with CCLS combined with root canal therapy and prosthodontic treatments[ 8 ]. Sajjad Ashnagar et al [ 24 ] reported that structurally compromised teeth have a reasonable long-term survival rate close to 80% after 10 years and patients with high fracture or caries risk may pose a higher chance of failure. Unfortunately, results of this current study cannot compare with previous studies because of differences of the criteria of case selection and success.…”

“…Short-term clinical outcomes of CCLS including periodontal indices, changes of free gingival margin, crown length, and bone level, have been reported [ 19 – 23 ]. The long-term outcomes of teeth preserved after CCLS are sparse [ 8 , 20 , 24 ].

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Aumento De Coroa Clínica Para Reabilitação Oral: Uma Revisão Narrativa E Relato De Caso

“…Indica-se o ACC funcional mediante a fraturas subgengivais, cáries subgengivais, procedimentos endodônticos com núcleos intra-radiculares ou na ocorrência de perfurações endodônticas, reabsorção radicular e tratamentos restauradores, como porção axial insuficiente para retenção de restauração, obter um remanescente dentário passível para retenção de coroas protéticas, bem como qualquer circunstância em que houver invasão do espaço biológico, indicando um meio desfavorável para tratamentos protético-restauradores, necessitando assim de maior exposição da coroa clínica [18]. sem que haja invasão dos tecidos de inserção supracrestais e, consequentemente, a ocorrência de resposta inflamatória crônica [10].…”