A Split‐Mouth Randomised Controlled Clinical Trial: Comparing Ostectomy Performed With Piezosurgery Versus Burs for Aesthetic Crown‐Lengthening Surgery

Aim To assess the clinical, profilometric, radiographic and patient‐reported outcomes following aesthetic crown lengthening (ECL) with ostectomy performed using either piezosurgery (PS) or rotary burs (RB). Methods Fifteen patients with altered passive eruption underwent ECL from maxillary premolar to premolar in a 6‐month split‐mouth randomised design. Ostectomy was performed with either PS or RB. Clinical, profilometric and radiographic assessments, as well as patient‐reported outcomes, were collected. The primary outcome was the change in gingival margin (GM) position between 6 weeks and 6 months, analysed with a linear mixed model with treatment as a fixed effect and patient as a random effect. Results Between 6 weeks and 6 months (primary outcome), GM change was 0.16 ± 0.19 mm in the PS group and 0.12 ± 0.21 mm in the RB group ( p = 0.170). The greatest reduction in crown height occurred between suturing and 7 days (−0.63 ± 0.35 mm). CEJ–BC remodelling from surgery to 6 months was −0.22 ± 0.42 mm ( PS ) and −0.26 ± 0.44 mm ( RB ) ( p = 0.491). Conclusion PS and RB showed no significant difference in GM stability following ECL, with the greatest changes in the first week and stability by 6 weeks.