What is crown lengthening with osteotomy, and how does it work?
Crown lengthening with osteotomy is a minor gum and bone operation that exposes more of a tooth's natural structure so that the tooth can be restored with a filling or crown. Despite the name, the tooth itself is not made longer. The gum is lifted, a small amount of the supporting jaw bone around the tooth is reshaped (the osteotomy, or more precisely ostectomy), and the gum is repositioned lower on the tooth. The purpose is to give the restoration something firm to grip, and to leave enough space between the new crown edge and the bone so that the gum stays healthy. Dental clinics in Turkey perform it either on its own or as part of a larger plan involving crowns, bridges or implants. Our general guide to crown lengthening covers the topic widely; this page deals with the version that includes bone reshaping.
This guide explains why bone is sometimes removed, how the operation is done, what it costs compared with the UK, US and Germany, how long healing takes before a crown can be made, and what the risks are. It forms part of our dental treatments in Turkey.
Why is bone removed, and what is biologic width?
Gum tissue attaches to a tooth in a fixed way. A band of about two millimetres above the bone (made of the gum's fibre attachment and a seal of cells) is known as the biologic width. If a crown edge or a broken tooth edge invades this zone, the gum tends to become inflamed, bleed and recede, or the bone may resorb, a problem described in periodontal literature. As a general rule, a dentist wants about three to four millimetres of healthy tooth structure between the planned crown edge and the bone. If the tooth has broken off at or below the gum line, or is badly decayed under the gum, trimming the gum alone does not create enough space, because the bone would remain too close. That is when the surgeon removes a little bone as well. Where the bone is already far enough away, a simple gum trim may be enough, as described in our page on gingivectomy.
Gum trim, osteotomy or orthodontic extrusion: which option fits?
The best choice depends on where the bone lies and how many teeth are involved. Your dentist should explain why they recommend one over the others.
| Option | Best suited to | Typical limits |
|---|---|---|
| Gum trim only (gingivectomy) | Excess gum, bone already well below the planned crown edge | Does not help if bone is too close to the edge |
| Crown lengthening with osteotomy | Broken or decayed tooth near the bone; short clinical crown | Some bone loss; effect on neighbouring teeth; careful in front teeth |
| Orthodontic extrusion | Single tooth in the front where bone and gum shape matter | Takes weeks of braces; extra visits |
If the tooth cannot be saved, extraction and an implant or bridge may be better; see dental bridge installation for the bridge alternative.
Does crown lengthening with osteotomy work?
Yes, for its purpose. Periodontal studies and reviews show that surgical crown lengthening predictably increases the amount of tooth available for restoration and allows crowns to be made with healthy margins. The evidence is less strong on how much the gum margin may move back (rebound) during healing: this is why many clinicians wait several weeks to months before the final crown, especially in the smile zone. The trade-off is that bone support around the treated tooth and often the neighbouring teeth is reduced, which matters more in teeth with already thin support. A responsible dentist will describe this loss and will not offer crown lengthening for teeth with poor long-term prospects.
How is the operation done, step by step?
- Examination, X-rays and sometimes a 3D scan to see the bone level, root length and neighbouring teeth.
- Local anaesthetic; the area is fully numbed.
- An incision along the gum and a flap is lifted to expose the bone.
- The surgeon reshapes bone with hand instruments or a fine burr or piezo device, to create the space needed, and smooths the contour.
- The gum flap is repositioned slightly lower and sutured in place. Sometimes a dressing is used.
- Stitches are removed after about one to two weeks.
A single tooth takes 30 to 60 minutes, and several teeth, such as when treating a gummy smile, may take one to two hours. A temporary crown is usually kept in place or made during healing.
Crown lengthening with osteotomy cost in Turkey compared with the UK, US and Germany
These are approximate per-tooth ranges for the surgery alone, not including crowns, and not hospital quotes. Prices depend on the number of teeth, whether both gum and bone are treated, the position (front teeth are more delicate) and whether a periodontist performs it.
| Country | Approximate cost range per tooth |
|---|---|
| Turkey | €100 – €450 |
| United Kingdom | €300 – €1,000 |
| United States | €600 – €2,500 |
| Germany | €250 – €900 |
What changes the price: the number of teeth, the use of a scan, whether the procedure is combined with a crown or with a crown or bridge, and the type of anaesthesia. A package may bundle the surgery, temporary crown, medication and the final crown; ask for each item to be listed and whether follow-up visits are included.
Who is a good candidate, and who is not?
Candidates are people with a tooth that has a short remaining crown, a fracture at or below the gum line, decay under the gum or a crown margin that has been encroaching on the gum, and whose tooth root is long enough to remain strong after some bone is removed. It is less suited to teeth with short roots, advanced gum disease, mobile teeth, very prominent front teeth where the gum line affects the smile, and patients with uncontrolled diabetes or who smoke heavily. Your dentist should treat gum disease first and should check that the bone removed will not weaken the tooth or its neighbours.
What does healing feel like, and how long before the crown?
Expect soreness, mild swelling and some bleeding or oozing in the first few days, controlled with painkillers; a cold pack helps. Most people eat soft food for several days and return to work after one or two days. Avoid brushing the area directly for the first week and use any rinse advised. Stitches come out after about one to two weeks, with soft-tissue healing largely complete after four to six weeks. Many dentists place the final crown after six to twelve weeks, longer in front teeth, so the gum margin has settled. The tooth may look longer and feel sensitive to cold at first; this usually fades.
How long should I stay in Turkey, and can crowns be done in one trip?
The surgery is quick, but healing sets the schedule. A common plan is two trips: the first for the surgery and temporary crown, a second after six to twelve weeks for the final crown. Some clinics shorten this with a seven to ten day stay and a provisional crown, then finish at home with your own dentist, but the gum may shift before the final crown is made. Ask the clinic for the full timeline in writing, and for whether a temporary crown will protect the tooth in the meantime.
What are the risks of crown lengthening with osteotomy?
Common effects are swelling, soreness, bleeding and sensitivity to cold. Less often there is infection, a longer-looking tooth, gum recession, exposed root surfaces that may feel sensitive or look different in colour, and food getting caught at the gap. A smaller bone height around the tooth and its neighbours may reduce support in the long term. In upper front teeth an uneven gum line can affect the smile, which is why precise planning and sometimes a wax-up or guide are used. The NHS and the American Academy of Periodontology describe these risks. Ask whether the neighbouring teeth will be affected and what happens if the gum line heals unevenly.
How do I choose a clinic, and what are the red flags?
Choose a clinic where the surgeon is a periodontist or an experienced dentist in oral surgery, who plans from X-rays and a scan, shows examples of healed cases and explains why bone removal is needed and not only a gum trim. Red flags include a plan without X-rays, a promise of a particular gum line, no waiting period before the final crown, and no explanation of the effect on neighbouring teeth. If the tooth needs a strong restoration afterwards, check the material, for example a zirconia crown, and who pays for any redo. Read how our process works and use the free quote form to receive a written plan and price.
Questions to ask the clinic before you travel
- Is bone removal necessary, or would a gum trim be enough?
- How much bone will be removed, and how will it affect neighbouring teeth?
- How long should the gum heal before the final crown?
- Will I have a temporary crown, and is it included?
- Is this one trip or two, and what does the price cover?
Hospitals with Dental Treatments in Turkey
Frequently asked questions
It is a surgery that lifts the gum and reshapes a little of the jaw bone around a tooth to expose more of its structure, so that a crown or filling can be placed with healthy margins. The tooth itself is not made longer.
If a tooth is broken or decayed at or below the gum line, trimming gum alone does not create enough space because the bone stays too close. Reshaping bone gives the gum room to heal without inflammation.
Yes, studies show it reliably exposes enough tooth for restoration. The gum margin can move during healing, so many dentists wait several weeks before making the final crown, particularly in the smile zone.
Approximately €100 to €450 per tooth in Turkey for the surgery alone, against about €300 to €1,000 in the UK. The price depends on the number of teeth, location and whether a crown is included.
The area is fully numbed during the operation. Afterwards expect soreness and swelling for a few days, usually controlled with simple painkillers and a cold pack.
Most people return to work in one or two days. Stitches come out after one to two weeks and the gum is largely healed after four to six weeks. The final crown is often made after six to twelve weeks.
Surgery is quick, but healing takes weeks. A common plan is a first trip of several days for surgery and a temporary crown, and a second trip after about six to twelve weeks for the final crown.
The tooth will look longer because more of it is exposed, and the gum line sits lower. This matters mostly in front teeth. The surgeon should plan the gum line carefully and show you what to expect.
Risks include swelling, infection, sensitivity, gum recession and reduced bone support around the tooth and its neighbours. Uneven gum lines can affect the appearance of front teeth. Careful planning reduces these risks.
Only if the bone is already far enough from the planned crown edge. If the bone is too close, a gum trim alone will not work, and the gum can become inflamed or regrow. X-rays and probing decide the choice.