A short clinical crown is a tooth that has less than 2mm of solid tooth structure between opposing parallel walls, meaning these crowns do not extend much above the gum line. The term "clinical crown" refers to the part of the tooth that is visible and can be directly examined by a dentist.
Causes of Short Clinical Crowns
Short clinical crowns may be caused by various factors, including:
Disease-related issues such as caries, erosion, or tooth malformation.
Trauma, including fractured teeth or attrition.
Latrogenic factors from dentistry, such as excessive tooth reduction or large endodontic access openings.
Eruption disharmony, which includes conditions like insufficient passive eruption or mesially tipped teeth.
Exostosis and genetic variations in tooth shape.
Solutions for Treating Short Clinical Crowns with Clear Aligners
Treating short clinical crowns with clear aligners can be challenging due to the small size of the teeth, which provides insufficient grip for the aligners. Typically, short clinical crowns have a tapered, triangular shape, lacking substantial points for retention. This often results in the aligners not seating properly on the teeth, leading them to slide or pop off. To address this issue during treatment, it's important to identify any short clinical crowns early and request attachments on the first or second premolars when submitting your case. Specify the placement of these attachments during the initial steps to avoid future fit issues. Additionally, retention pliers (dimple pliers) can be used to create retention points at the gumline, aiding in proper aligner seating. Always check for short clinical crowns during patient evaluations, especially if the first set of aligners does not fit well. This proactive approach allows you to request necessary attachments promptly, ensuring effective treatment from the start.