Periodontal evaluation of crown-root fractured teeth following modified crown lengthening surgery

Key Points Helps clinicians recognise a feasible and minimally invasive therapeutic option for management of crown-root fractured teeth. Provides advice on how to achieve the desired outcomes of modified crown lengthening surgery. Provides evidence-based support to save and restore subgingival crown-root fractured teeth through modified crown lengthening surgery combined with endodontic treatment and post and core restoration. Helps in the understanding of factors that affect the periodontal health of teeth after modified crown lengthening surgery and crown restoration. Objectives To evaluate long-term outcomes of modified crown lengthening procedures for crown-root fractured teeth, and to analyse factors that affect the periodontal health of the treated teeth. Methods The present study retrospectively analysed data from 22 patients (13 males and 9 females) who had presented with crown-root fractured teeth and received modified crown lengthening procedures combined with crown restoration for ≥13 months. In total, 26 crown-root fractured teeth were treated and examined for plaque index, probing depth, bleeding index, bleeding on probing, mobility and the crown margin location. The contralateral tooth and ipsilateral teeth mesial and distal to the treated tooth were used as controls. Data were assessed descriptively or analysed statistically with Mann-Whitney-U test at α=0.05. Results Recorded periodontal indices revealed stable periodontal status in 25 of 26 treated teeth with the mean values for aesthetic and functional VAS scores at 9.5. A negative correlation was observed between the subgingival crown margin location and the bleeding index. Conclusions The modified crown lengthening procedure is a feasible and minimally invasive therapeutic option for management of crown-root fractured cases.