Esthetic Rehabilitation of Gummy Smile by Osteoplasty and Crown Lengthening Procedure: A Clinical Case Report

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.

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An unusual endodontic complication following crown lengthening surgery: A Case Report.

Journal Of Oral Research ◽

10.17126/joralres.2021.020 ◽

2021 ◽

Vol 10 (2) ◽

pp. 1-6

Author(s):

Tong Wah Lim ◽

◽

Teng Kai Ong ◽

Keyword(s):

Computed Tomography ◽

Case Report ◽

Cone Beam Computed Tomography ◽

Root Resorption ◽

Rare Complication ◽

Cone Beam ◽

Present Case Report ◽

Dentine Hypersensitivity ◽

Crown Lengthening ◽

Gummy Smile

A gummy smile is a form of excessive gingival display when smiling. The excessive gingival display due to altered eruption is likely to benefit from crown lengthening surgery in order to restore the esthetic smile. Case Report: The potential complications of the crown lengthening surgery include possible esthetic deformities, dentine hypersensitivity, transient mobility, and root resorption. The present case report reveals a rare complication happened after an esthetic crown lengthening surgery which was performed to correct the gummy smile of a 37-year-old female. The patient experienced dull throbbing pain and mild tender to percussion on tooth 11, 3 weeks after the surgery, and the symptoms did not improve after the composite restorations were placed at the cervical regions. Instead, the tooth was tender to percussion and palpation with a sign of coronal discoloration. Pulp necrosis was confirmed with the clinical tests. A cone-beam computed tomography was taken after the root canal treatment, and apical fenestration on tooth 11 was noted. Therefore, this case report shows the possible correlation between crown lengthening surgery on a tooth with apical fenestration and pulp necrosis, if the apical vasculature is severed accidentally during the procedure. Conclusion: A cone-beam computed tomography should be considered prior to the surgery and extra precaution during the surgery may reduce the risk of severing the apical vasculature if apical fenestration is evidenced.

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Crown Lengthening as Treatment for Altered Passive Eruption: Review and Case Report

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1338 ◽

2015 ◽

Vol 6 (3) ◽

pp. 178-183

Author(s):

Mateus Rodrigues Tonetto ◽

Shelon Cristina Souza Pinto ◽

Matheus Coelho Bandeca ◽

Suellen Nogueira Linares Lima ◽

Cristian Higashi ◽

...

Keyword(s):

Case Report ◽

Correct Diagnosis ◽

Strong Association ◽

Invasive Technique ◽

Adequate Treatment ◽

Periodontal Tissues ◽

Choice Of Treatment ◽

Smile Esthetics ◽

Crown Lengthening ◽

Gummy Smile

ABSTRACT This case report relates a patient with altered passive eruption (APE) treated with surgical crown lengthening. There is a strong association between smile esthetics and periodontal tissues. ‘Gummy smile’ constitutes a relatively frequent esthetic disadvantage characterized by excessive display of the gums during upper lip smiling. One situation that can lead to gummy smile is APE. There are many important diagnostic factors connected with APE. These include making a correct diagnosis; considering facial and oral features before considering the most appropriate periodontal treatment. A 21-year-old female patient presented to the dental clinic expressing to be discontent with her smile, due to the display of gingiva when she smiles. Before choosing the adequate treatment, esthetics and periodontal factors were analyzed. In the present case report, surgical crown lengthening was the treatment chosen. Through a correct diagnosis and technique, it was possible to obtain harmony in the smile. Crown-lengthening surgery is an important choice of treatment, because it is a less invasive technique and it permits the establishment of an esthetical smile. How to cite this article Pinto SCS, Higashi C, Bonafé E, Pilatti GL, Santos FA, Tonetto MR, Lima SNL, Bandéca MC. Crown Lengthening as Treatment for Altered Passive Eruption: Review and Case Report. World J Dent 2015;6(3):178-183.

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Esthetic crown lengthening: a case report

Journal of Research in Dentistry ◽

10.19177/jrd.v3e32015678-687 ◽

2015 ◽

Vol 3 (3) ◽

pp. 678

Author(s):

Rodolfo José Gomes De Araújo ◽

Felipe Vilhena Brilhante ◽

Jacy Leite Mattos ◽

Flávia Medeiros Aliverti Alves ◽

Bruna De Fátima Soares Do Nascimento ◽

...

Keyword(s):

Case Report ◽

Undergraduate Students ◽

Scientific Article ◽

Crown Lengthening ◽

Gummy Smile ◽

Clinical Cases

The periodontal plastic surgeries have been valued and sought by people who claim they want to correct “gummy smile”, which happens when one has expose more gum than teeth when smiling. There are many causes for the gummy smile, this scientific article covers four cases of altered passive eruption of the teeth with excess keratinized gingiva. The harmonic smile disturbed aesthetic is a discomfort that troubles many people, especially women. Based what has been discussed so far, this paper has as main objective report clinical cases of esthetic periodontal surgeries osteoplasty made by undergraduate students of the dentistry program. Such techniques promote a more adequate dental exposure and create anharmonical smile on the patient. The cirurgical procedures were indicated based on the analysis of the smiles. After the procedures were made, we conclude the techniques used were suitable based on the satisfaction of the patient and that they were easy to execute in order to obtain an aesthetic smile.

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Virtual Planning and Rapid 3D Prototyping Surgical Guide for Anterior Crown Lengthening Surgery: A Clinical Case Report

Journal of Prosthodontics ◽

10.1111/jopr.13471 ◽

2021 ◽

Author(s):

Jaewon Kim ◽

Yu‐Chun Lin ◽

Michael Danielak ◽

Minh Van ◽

Du‐Hyeong Lee ◽

...

Keyword(s):

Case Report ◽

Clinical Case ◽

Virtual Planning ◽

Surgical Guide ◽

Crown Lengthening

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Pre prosthetic crown lengthening: an esthetic and functional procedure. A case report

Revista Estomatología ◽

10.25100/re.v18i2.5714 ◽

2017 ◽

Vol 18 (2) ◽

pp. 23-26

Author(s):

Carlos Bernardo Aguelo ◽

Juan Manuel Rico ◽

Pablo Emilio Molano

Keyword(s):

Case Report ◽

Surgical Procedure ◽

Clinical Case ◽

Surgical Techniques ◽

Daily Practice ◽

Great Frequency ◽

The Moment ◽

Crown Lengthening

Crown lengthening is a procedure widely used in periodontal practice, for esthetic procedures and also for pre-prosthetic ones; situation that is present with great frequency in the daily practice in periodontics. It is very important the knowledge of the anatomic structures of the periodontal anatomy in order to do a proper surgical procedure, preceded by a deep clinical and radiological exam and a pertinent treatment prosthetic plan. It is also important that the clinician knows all the surgical techniques, because not all the procedures need the same approach and there are certain anatomic and surgical characteristics that must be taken in concern at the moment of planning a surgical crown lengthening. In this article we present a clinical case where it is integrated the periodontal and prosthetic discipline.

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Laser‐Assisted Lip Repositioning With Smile Elevator Muscle Containment and Crown Lengthening for Gummy Smile: A Case Report

Clinical Advances in Periodontics ◽

10.1002/cap.10060 ◽

2019 ◽

Vol 9 (3) ◽

pp. 135-141

Author(s):

Balaji Ganesh ◽

Nalina Kumari C. Burnice ◽

Jaideep Mahendra ◽

Rajaram Vijayalakshmi ◽

Anil Kumar K.

Keyword(s):

Case Report ◽

Crown Lengthening ◽

Gummy Smile

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Gummy Smile Treatment by Aesthetic Crown Lengthening on Altered Passive Eruption Case

Acta Medica Philippina ◽

10.47895/amp.v55i8.2122 ◽

2021 ◽

Vol 55 (8) ◽

Author(s):

Noer Ulfah ◽

I Komang Evan Wijaksana

Keyword(s):

Case Report ◽

Treatment Plan ◽

Primary Treatment ◽

Chief Complaint ◽

Central Incisor ◽

Height Ratio ◽

Aesthetic Results ◽

Subtype A ◽

Crown Lengthening ◽

Gummy Smile

An attractive smile enhances the appearance and acceptance of an individual in society. Gum exposure more than 3 mm is generally considered unattractive and known as a gummy smile, which is usually considered an aesthetic problem. At present, patients have a greater desire for more aesthetic results that may influence the planning of dental treatments. This case report aimed to describe the surgical sequence of aesthetic crown lengthening to improve smile profile and eliminate gummy smile. We reported a 21-year-old non-smoking woman with no pertinent medical history who presented with a chief complaint of an unattractive smile due to excessive gingival display. The gingival display in the smile was 5 mm, and the width to height ratio of the central incisor was 121%. Neither periodontal problems nor teeth mobility was detected. Assessment for the condition was excessive gingival display due to altered passive eruption. The overall prognosis for this case was good. The primary treatment plan proposed to the patient was an aesthetic crown lengthening. Altered passive eruption class I subtype A was a case conclusion, and aesthetic crown lengthening with gingivectomy without osseous reduction was the selected treatment. In conclusion, aesthetic crown lengthening should be considered as a surgical component of aesthetic therapy to improve smile profile and eliminate gummy smile.

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