Flapless aesthetic crown lengthening: A new therapeutic approach

Aesthetic crown lengthening is one important chapter in contemporary periodontology. Traditionally, this procedure is performed using a flap elevation to a full exposure of the underling bone to allow for osteotomy/osteoplasty. However, in well-indicated cases, it is possible to meet that purpose using a flapless approach; i.e. without a flap elevation, in which the osteotomy is performed through the gingival sulcus using proper micro-chisels. To do this, it is important to have an adequate width of keratinized tissue and a bone crest not considered thick (thin and intermediate tissue biotypes). Among the benefits of this breaking-through procedure are low morbidity with no sutures, less bleeding, greater patient acceptance, and immediate outcome. As long as the indications are respected and the learning curve is left behind, predictable outcomes are expected. Flapless aesthetic crown lengthening is one alternative minimally invasive approach which, when indicated, offers realistic clinical benefits to our patients.