Precision Crown Lengthening with a Metal-Combined Guide: A Dental Technique

PURPOSE. This study presents a surgical technique for crown lengthening using a metal-combined guide, aimed at minimizing the gap between the bone surface and the guide to reduce visual and surgical errors. MATERIALS AND METHODS. The protocol includes: 1) Preoperative data acquisition through cone beam computed tomography (CBCT), intraoral scanning, and periodontal probing; 2) Creating a digital diagnostic wax-up to guide the design of the gingivectomy guide plate; 3) The elaboration of the alveolectomy guide plate and its combination structures, followed by the fabrication of the metal-combined guide; 4) Precisely placing the gingivectomy guide to assist in the gingivectomy procedure; 5) The subsequent removal of the gingivectomy guide, enabling the execution of alveolectomy and osteoplasty procedures; and 6) The provision of comprehensive post-operative care, encompassing temporary restoration, adjustment of adjacent contact points, final restoration, and scheduled follow-up visits. CONCLUSIONS. This technique utilizes digital technology to integrate various datasets for designing and fabricating a metal-combined guide, improving the precision of bone removal and leading to more predictable treatment outcomes. This approach is particularly beneficial for patients with maxillary overdevelopment and lingual tilt of the anterior teeth, or maxillary underdevelopment with lip tilt of the anterior teeth.