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Periodontics/Misunderstanding ?

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Question
Dear Dr. Scharf,

I wanted to reply to your most recent post regarding my questions on crown lengthening, but that option was not available. Therefore I opened a new dialogue.
As you stated "good job on the crowns", I realized that there may be a misunderstanding.It appears, you looked at crown # 29 and maybe also crown # 31 (a 3-piece-bridge). Crowns # 29 and # 31 are indeed excellent crowns, I agree with you. The bridge is still in place and never caused any problems. The bridge was done by a different dentist than the dentist who did the crown on # 28. My original post was about crown # 28 only, which came off in only 14 months after cementation, not the other crowns. The crown on # 28 was not retained adequately evidently. The bone levels (both distal and misial) are the same, in the BEFORE and AFTER x-rays. The x-rays show no bone reduction in the bones around tooth # 28. Would you mind looking at the x-rays again, only at tooth/crown # 28 ? Sorry about the misunderstanding.

Answer
Crown lengthening is done for multiple reasons.  The first is to establish biologic width.  That is, if the decay is too close to the bone the bone is reduced somewhat so that the crown margin is not too close to the bone.  It appears that this was done on the distal of #28.  Crown lengthening is  also done to make a tooth longer to increase retention of the crown.  In that case typically the crown lengthening is done around the circumference of the tooth.
Best regards

Periodontics

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David Scharf

Expertise

I am a board Certified periodontist which means that I am an expert in treating gum disease (periodontal disease) and placing dental implants. I can answer questions related to treating gum disease, bleeding gums, maintaining healthy gums, and structural issues with the gums such as recession, to gummy a smile, crown lengthening etc. I am also certified in Laser Periodontal therapy which allows me to treat gum disease with a laser rather than a scalpel. I can address those questions as well.

Experience

I have been practicing periodontics and placing dental implants since 1990. I have treated thousands of patients for both gum disease and dental implants. I currently an a Clinical Assistant Professor in the Department of Periodontics and Implant Dentistry at the nations largest dental school.

Publications
Journal of the American Dental Association, Journal of Periodontology, International Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxilofacial Implants

Education/Credentials
BA/DMD Boston University Cum Laud. Certificate of Advanced Graduate Study in Periodontics fro New York University. Board Certification in Periodontics 1995

Awards and Honors
e was elected to Omicron Kappa Upsilon (the "Phi Beta Kappa" for dentists), and received the Boston University award for Excellence in Periodontology, the Boston University Predoctoral Prosthetic Award for Excellence in Prosthetics, and the Academy of General Dentistry Outstanding Senior Student Award, the Boston University Operative Dentistry Special Achievement Award, and the Quintessence Publishing Company Outstanding Senior Award for Excellence in Clinical Practice. Following dental school, Dr. Scharf completed a year long General Practice Residency at The Long Island College Hospital in Brooklyn, New York. As a resident at this top New York program, he gained extensive clinical experience in such fields as prothodontics, periodontics, endodontics, orthodontics, oral surgery, management of the medically compromised patient, and general dentistry. This experience was completed by clinical rotations in the departments of general medicine, anesthesia, and emergency medicine.

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