Myths about gingival response to crowns.

In response to the informative article written by Dr. Omar El-Mowafy in the December 2007/January 2008 issue of the JCDA,1 I would like to offer some comments from a different perspective and with different conclusions. The article suggested that the tissue of a 25-year-old, otherwise healthy gentleman was inf lamed around porcelain-fused-to-metal (PFM) crowns on both maxillary central incisors due to poor fit and overextension of the crown margins into the interproximal gingival spaces. Once the crowns were replaced with new, more perfectly shaped and fitted crowns, the tissue returned to health. Although these factors likely played a role, I believe the main culprit was overlooked; I suggest that the tissue response was primarily due to the fact that the original restorations contained metal and the replacement crowns did not. Over the past 10 years, I have generally considered biologic width preservation of secondary importance, in favour of optimizing esthetics by using metal-free prosthetics and without resorting to highly invasive surgical crown-lengthening procedures. In my experiMyths about Gingival Response to Crowns