Open flap crown lengthening in Turkey: what it is and how it works
Open flap crown lengthening is a gum and bone procedure that exposes more of a tooth above the gum line. The dentist or periodontist lifts the gum like a small flap, reshapes the bone that holds the tooth if needed, and repositions the gum at a lower level so that the tooth appears longer and has enough healthy structure above the bone for a crown, filling or bridge to grip. It does not change the tooth itself; it changes the gum and bone around it. The same operation is offered in dental hospitals in Turkey as a preparation for restorations.
This guide explains when the operation is needed, how it is done, what the evidence says, what it costs compared with the UK, US and Germany, how long the mouth takes to heal before the crown is made, and how to choose a clinic. See also our overview of dental treatments in Turkey.
Why does a tooth need crown lengthening before a crown?
A crown needs a ring of healthy tooth to hold on to, and the edge of the crown must sit on sound tooth, not on the bone. Dentists speak of the "biologic width": a band of roughly 2 mm of gum attachment that must stay above the bone, and the crown margin must lie above it. If decay or a fracture has destroyed the tooth down to or below the gum line, a crown edge placed there will press on this attachment, causing inflamed, bleeding gums and sometimes bone loss around the tooth.
Crown lengthening is therefore advised in four typical situations: a tooth broken at or below the gum, deep decay near the bone, a very short clinical crown (for example after wear or after a previous root-canal treatment), and, in the cosmetic form, a "gummy" smile where too much gum shows. Open flap surgery is chosen when bone must be reshaped, not only gum.
How is open flap crown lengthening done, step by step?
The procedure is done under local anaesthesia and takes about 30 to 90 minutes, depending on how many teeth are treated. First the dentist measures the gum and bone with a probe and X-rays or a 3D scan. Next an incision is made along the gum margin and the flap is lifted from the bone. A small amount of bone is removed and smoothed with hand instruments or a fine drill, typically 3 to 4 mm of tooth is exposed above the new bone level, and the root surface is cleaned. The flap is then positioned lower on the tooth and stitched, and a dressing may be placed to protect it.
Because the bone is touched, this is the key difference from a gingivectomy, where only gum tissue is trimmed. A gingivectomy is enough when there is plenty of space between the bone and the planned crown edge, and an open flap approach is needed when there is not.
Open flap, gingivectomy or crown lengthening with osteotomy?
Several names are used, and they are not always the same operation. The table sets out how they differ.
| Technique | Best suited to | Typical limits |
|---|---|---|
| Open flap crown lengthening | Teeth where bone must be reshaped to give 3 to 4 mm of space | Needs a flap and stitches; gum recedes slightly during healing |
| Gingivectomy (gum trim only) | Excess gum with enough distance to the bone | Cannot create space when the bone is too close |
| Crown lengthening with osteotomy | Larger bone reshaping across several teeth | More bone removal; longer healing; check neighbouring teeth |
If the tooth is too damaged to be saved, an implant may be a better choice; see dental implants and, for replacing a missing tooth between neighbours, dental bridge installation.
Does open flap crown lengthening work? What the evidence says
Studies and periodontal textbooks consider surgical crown lengthening a predictable way to give a restoration a stable margin when done with enough remaining bone support. Its success is measured not as a cosmetic gain but as a healthy gum after the crown is fitted. What the evidence does not support is a guarantee that the gum stays exactly where it is placed: after surgery the gum can move slightly, often by about 1 mm or more in the first months, which is why the final crown is made only after healing. Teeth with short roots or little bone left after lengthening can become more mobile, and a surgeon should tell you honestly when the tooth is not worth saving this way.
Open flap crown lengthening cost in Turkey compared with the UK, US and Germany
The approximate ranges below are for one to three teeth in the same area and do not include the crown. They are not hospital quotes, and each clinic confirms its own price in writing after examination and X-rays.
| Country | Approximate cost range |
|---|---|
| Turkey | €120 – €500 per tooth |
| United Kingdom | €350 – €1,100 per tooth |
| United States | €500 – €1,600 per tooth |
| Germany | €300 – €1,000 per tooth |
The price depends on how many teeth are treated, whether bone is reshaped, the use of sedation, a specialist periodontist or a general dentist, and 3D imaging. Because the operation prepares a tooth for a crown, ask for the crown and any root-canal treatment in the same written quote and check that the interval between the operation and the crown fits your trip.
Who is a good candidate for open flap crown lengthening?
Good candidates are adults with a tooth that cannot take a crown because too little sound structure shows, who have enough root length and bone to spare, and whose gums are healthy or can be made healthy before surgery. You may need a different plan if the tooth has a vertical root fracture, is very loose, has a very short root, is part of a visible front smile where gum loss would look unattractive, or if you have uncontrolled diabetes, smoke heavily or have untreated gum disease. In those cases the dentist may suggest orthodontic extrusion (slowly pulling the tooth up), extraction and an implant, or a different crown design.
What is healing like, and how long before the crown?
You usually feel soreness and mild swelling for two to three days, easily controlled with simple painkillers. Stitches come out after 7 to 14 days. You avoid hard, hot or sharp food on that side, rinse with an antibacterial mouthwash and brush gently around the area. The gum needs time to reach its final position: a temporary crown may be fitted within days, but the final crown on a back tooth is normally made after four to six weeks, and on a front tooth, where the gum line shows, often after two to three months.
For travellers this matters. A plan with a temporary crown and a second visit, or a plan where the final crown is made at home by your own dentist, should be agreed before you fly. Most patients stay three to five nights for the surgery, suture check and temporary restoration.
What are the risks of crown lengthening surgery?
Common effects are swelling, mild bleeding and sensitive teeth to cold for some weeks because the root is more exposed. Less common problems are gum recession that shows the crown margin, a longer-looking tooth, loosening of the tooth when much bone is removed, loss of the tiny gum triangles between teeth, infection and a poor fit if the final crown is made too early. These risks rise with heavy smoking and poor oral hygiene. The American Academy of Periodontology and the NHS both advise a full gum assessment before restorative work, and a surgeon should explain which of these risks apply to your tooth.
How to choose a clinic and what to ask
Check that the dentist or periodontist performs this operation regularly, that X-rays or a 3D scan are used before and after, that the clinic works in a licensed facility and that you receive a written plan with the interval before the crown and the price of the crown itself. Red flags include removal of bone with no measurement, a crown placed on the same day as the surgery, promises that the gum will not move and no plan for follow-up. Read how our process works and request a plan through the free quote page.
- How many millimetres of tooth will be exposed, and how much bone will be removed?
- Will this change how my smile looks, and for which teeth?
- When will the final crown be made, and where?
- Is a temporary crown included?
- Are there alternatives, such as extrusion or an implant, for this tooth?
- What does the price include?
Hospitals with Dental Treatments in Turkey
Frequently asked questions
It is a gum and bone operation that exposes more of a tooth. The dentist lifts the gum, reshapes a little bone and moves the gum lower, so a crown or filling has healthy tooth to grip and a stable edge.
It is needed when a tooth is broken or decayed at or below the gum line, or is too short for a crown. The crown edge must sit above the gum attachment, so space is created surgically.
It is a predictable way to give a restoration a stable margin when enough bone support remains. The gum can settle by around a millimetre or more, so the final crown should wait until healing is complete.
Approximate ranges are €120 to €500 per tooth in Turkey, against about €350 to €1,100 in the UK. The crown is extra. The clinic confirms its price in a written quote after examination.
The area is numbed during surgery. Afterwards most people have soreness and mild swelling for two or three days, usually controlled with simple painkillers. Cold sensitivity may last some weeks.
Stitches come out after 7 to 14 days and the gum settles over four to twelve weeks. Back-tooth crowns are usually made after four to six weeks, front teeth often after two to three months.
A gingivectomy only trims gum tissue and works when there is enough space above the bone. Open flap crown lengthening also reshapes bone, so it is used when the bone is too close to the planned crown edge.
Yes, treated teeth look longer, and the gum line can change. For front teeth the surgeon should show a plan or mock-up first so that the result suits your face and smile.
Risks include gum recession, cold sensitivity, a longer-looking tooth, loss of small gum triangles and, rarely, loosening of the tooth when much bone is removed. Good hygiene and no smoking reduce the risk.
Usually three to five nights for surgery, a stitch check and a temporary restoration. The final crown may need a second visit weeks later, or can be made by your own dentist at home.