Objectives: The purpose of the present investigation was to evaluate the five year periodontal outcome of mandibular molars treated with crown lengthening procedure prior to a single crown restoration.

Methods: Seventeen patients (nine males and eight females; age 48.1 ± 7.8) fitting this criteria were selected from the patient pool at Boston University. They had been initially referred to the Periodontology Clinic for crown lengthening prior to restorative work. The surgical procedures were carried out by periodontal residents. The main surgical objective was to recreate the lost biological width in order to allow for the placement of a restoration that would be respectful of the gingival and periodontal tissues. A dimension of three millimeter coronal to the alveolar crest was deemed necessary to permit healing and proper restoration of the tooth. All the restorative work was completed by the students of the school within one year from the initial consulation.

Results: The treated patients were then retrospectively evaluated five years after crown cementation, by comparing pre- and post-treatment bitewing radiographs. Seven patients out of seventeen (41%) presented with clear radiographic signs of furcation involvement five years after crown cementation.

Conclusions: These results suggest the need for more accurate case selection in the preoperative phases of therapy. The advantage/disadvantage of a crown lengthening procedure should be carefully evaluated in light of negative outcomes due to anatomical limitations and extent of dentinal decay.

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