(1) Pre-operative alginate is taken from the conventional model and photographs of the patient are taken inside and outside the mouth.

(2) The surgeon designs a diagnostic wax-up and makes a pressure film guide on the diagnostic wax-up.

The periodontist performs the periodontal crown lengthening surgery under the guidance of the pressure film guide: The incision in the affected area is positioned according to the ideal gingival margin position on the guide and the excess gingiva is excised; the guide is removed, the flap is incised and the alveolar bone is exposed, and the position of the bone apex in the operation requires a combination of the indication of the periodontal probe [11 , 12 (link)] and a combination of the use of the shu two-armed ruler to indicate the position of the bone crest apex [13 (link)], and the alveolar bone is removed using a bone chisel/bullet drill so that the gingival margin is at least 3 mm from the crest of the alveolar ridge to match the biological width and is displaced towards the crest of the adjacent teeth.

(4) Fabricate the temporary restoration: Remove the sutures after 1 week and refer to a prosthodontist for tooth preparation and chairside fabrication of DMG resin temporaries concerning the diagnostic wax-up.

(5) Follow-up observation: Wear the temporary crown after surgery and record the amount of gingival change, red and white aesthetic index and patient satisfaction at 4 weeks, 3 months and 6 months to evaluate the clinical restoration effect. Since the gingiva will change over time after crown extension surgery, the prosthodontist should adjust the shape of the temporary crown according to the patient's intraoral situation when the patient wears it for inspection, so that the gingiva is better guided and shaped.

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