What determines the necessity for bone removal during “crown lengthening”?

The necessity for bone removal during "crown lengthening" is primarily determined by the need to expose more tooth structure and aesthetic considerations. Crown lengthening is a surgical procedure typically performed to correct a gummy smile or to prepare a tooth for an appropriate crown placement when there isn't enough tooth structure above the gum line. This involves removing both soft tissue and bone to ensure that the crown has adequate retention and esthetic appearance.

When considering aesthetic outcomes, additional tooth structure must be revealed to achieve a desirable proportion between the clinical crown and the gingiva. If there is insufficient tooth structure available due to the position of the gum line, bone removal becomes necessary to create the right proportions and achieve a more balanced and naturally appearing gum line. This aspect highlights the importance of both functional and aesthetic considerations when planning for crown lengthening.

Other options, such as the depth of the gum tissue, patient's age and gender, or the material of the crown, do not directly dictate the need for bone removal. While the depth of the gum tissue may influence surgical approaches, it doesn't solely determine whether bone is needed to be removed. Similarly, age, gender, or crown material considerations are generally not pertinent to the surgical requirements of bone removal in crown lengthening procedures.