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Esthetic crown lengthening in the treatment of gummy smile

The aim of this article was to evaluate 1 year after surgerya surgical protocol that included gingivectomy and an apically positioned flapplus osseous resective surgery to correct excessive gingival display (EGD) inpatients with altered passive eruption (APE) of the maxillary anterior teeth.Six female patients aged 18 to 22 years were diagnosed with APE type 1B.Surgical crown lengthening with flap surgery and bone recontouring wasperformed to achieve the biologic width. Photographic images were analyzed toevaluate the stable improvement of crown length before the procedure(baseline), immediately after surgery (immediate postoperative), and at 3 and12 months postsurgery. Moreover, a lip repositioning procedure was alsoperformed in one case to complement the periodontal therapy. Compared withbaseline, an increase of 1.6 mm in the mean tooth crown height was observed inthe photographic analysis at 12 months. A minimal difference was observedbetween the mean tooth crown height immediate postoperative and at 12 months,which indicates stability of the gingival margin. In conclusion, the surgicalprotocol outlined in this article describing esthetic crown lengthening for thetreatment of APE/gummy smile resulted in predictable outcomes and stability ofthe gingival margin 1 year after surgery. more

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