The Modern Concept of the Problem of Short Clinical Crowns

Short clinical crowns of teeth significantly complicate the qualitative restoration of functional and aesthetic indicators of the dentofacial system. Often, therapeutic, orthopedic treatment of patients with low clinical crowns becomes impossible without prior surgical correction. This study was aimed to analyze domestic and foreign literary sources to identify the main problems associated with low clinical crowns of teeth and modern approaches to solving them. Results. It was analyzed that the causes of short clinical crowns include eruption anomalies, occlusal disorders, diseases of hard dental tissues (caries and its complications, especially in the case of subgingival defects of the tooth crown, non-carious lesions), injuries (tooth fracture, abrasion), iatrogenic effects during dental interventions (reduction of a superfluous tooth, creation of wide endodontic access). A short clinical crown makes it impossible to have a high-quality fixation of the orthopedic structure and causes a violation of the occlusal curve and aesthetic parameters - the relief of the gum line. Preserving the dental crown, a fundamental aspect of prosthetics, depends on tooth preparation, choice of cement, and crown-tooth contact. For high-quality dental restoration, the placement of the tooth in the dental arch, its strategic importance, the state of the periodontium, the ratio of the crown to the root, the state of occlusion, the feasibility of endodontic treatment, and aesthetics are assessed. A thorough examination includes a clinical examination, assessment of the periodontal biotype, radiographic examination, and analysis of the diagnostic impression with the condition of further visualization of the desired treatment result. In each case, the problem of apical displacement of the gingival margin arises, which can be both within the soft tissues and with the capture of hard ones - removal/alignment of the edge of the bone walls or simultaneous interventions. Important factors are the "biological width" of the dentogingival junction, the level of gingival keratinization, and the height of the clinical crown when deciding on the type and depth of intervention. Today, surgical lengthening of the tooth crown is used as a guided preparation of soft and hard tissues to expose a greater height of the tooth structure. Among modern techniques, a diode laser and piezosurgery are considered, characterized by minimally traumatic surgical interventions and rapid healing. Conclusions. The literature review demonstrates the relevance of the issues and possibilities of modern methods of surgical correction in the case of a short clinical crown of the tooth. Scientists focus on the prevalence of such clinical conditions of the teeth and consider the anatomical, functional, and aesthetic characteristics of dental treatment. However, the issues of a differentiated approach in the case of choosing a method of implementation - gingivectomy/resection of soft and hard tissues around the tooth, as well as individualized methods of their implementation, taking into account effective methods of postoperative healing in order to prevent soft tissue recession, remain insufficiently studied.