Esthetic Crown Lengthening with Ostectomy for The Correc-tion of Gummy Smile: A Case Report
DOI:
https://doi.org/10.46862/interdental.v22i2.14017Keywords:
altered passive eruption, crown lengthening, ostectomy, gummy smileAbstract
Introduction: Short clinical crowns may lead to esthetic concerns, particularly excessive gingival display (gummy smile).
Case: A 25-year-old female presented with a chief complaint of short teeth and excessive gingival display during smiling. Clinical examination revealed a gingival display of more than 2 mm, with no signs of periodontal inflammation and adequate keratinized gingiva. The diagnosis was excessive gingival display due to altered passive eruption type IB in the region of teeth 15–25.
Case Management: Crown lengthening with a full-thickness flap and ostectomy was performed. Follow-up evaluations up to one month demonstrated favorable healing, patient satisfaction, no spontaneous bleeding or periodontal pocket formation, and stable treatment outcomes.
Discussion: Accurate identification of altered passive eruption and appropriate management of the supracrestal tissue attachment are critical for successful esthetic crown lengthening. In this case, osseous resection was necessary to establish adequate periodontal dimensions and achieve stable esthetic outcomes.
Conclusion: Crown lengthening with ostectomy is an effective and predictable treatment modality for altered passive eruption type IB.
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1. Brizuela M, Ines D. Excessive Gingival Display. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; update 2023 Mar 19 [cited 2026 Apr 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470437/
2. Tatakis DN, Silva CO. Contemporary treatment techniques for excessive gingival display caused by altered passive eruption or lip hypermobility. J Dent. 2023;138:104711. DOI:10.1016/j.jdent.2023.104711.
3. Amro LA, Abdalwahab MM, Zazou N, Amr AEH. The psychological effect of excessive gingival display on Egyptian females. ScientificWorldJournal. 2025;2025:9996803. DOI:10.1155/tswj/9996803.
4. Saavedra-Alcalá N, González-Martínez LE, Martínez-Sandoval G, Garza-Enríquez M, Rodríguez-Pulido JI, Baltazar-Ruiz A. Esthetic crown lengthening in the treatment of gummy smile associated with altered passive eruption: A case report. Int J Interdiscip Dent. 2024;17(1):39–41. DOI:10.4067/S2452-55882024000100039.
5. Arifagaoglu O, Yilmaz U. Analysis of gingival display during static and dynamic smiles in a Turkish sample: a clinical study. Eur Oral Res. 2022;56(1):23–27. DOI:10.26650/eor.2022888850.
6. Inchingolo AD, Inchingolo AM, Viapiano F, Netti A, Ciocia AM, Ferrara I, et al. Effectiveness and personalized approaches in the correction of gummy smile: A systematic review of orthodontic and surgical treatments. J Clin Med. 2024;13(22):6843. DOI:10.3390/jcm13226843.
7. Qali M, Alsaegh H, Alsaraf S. Clinical considerations for crown lengthening: A comprehensive review. Cureus. 2024;16(11):e72934. DOI:10.7759/cureus.72934.
8. Storrer CLM, Valverde FK, Santos FR, Deliberador TM. Treatment of gummy smile: gingival recontouring with the containment of the elevator muscle of the upper lip and wing of nose: A surgery innovation technique. J Indian Soc Periodontol. 2014;18(5):656–660. DOI:10.4103/0972-124X.142468.
9. Handayani DMP, Nursolihati V, Hafiyyah OA. Lip repositioning with internal suturing and crown lengthening in a single visit: case report. Interdental J Kedokt Gigi. 2024;20(2):335–343. DOI:10.46862/interdental.v20i2.7861.
10. Horn ROR, Joly JC. Treatment of gummy smile combining crown lengthening, lip repositioning, and the use of polyester threads. Clin Adv Periodontics. 2023;13:42–45. DOI:10.1002/CAP.10214.
11. Rakmanee T, Phromngam Y, Thipraksa R, Janaphan K. Clinical and radiographic assessment of gummy smile patients with altered passive eruption: a cross-sectional study in a Thai population. Clin Oral Investig. 2024;28(10):530. DOI:10.1007/s00784-024-05919-5.
12. Bajaj P, Bhombe KR, Oza RR. Periodontal management of gummy smile due to altered passive eruption: a case report. Cureus. 2022;14(9):e29174. DOI:10.7759/cureus.29174.
13. Arora R, Narula SC, Sharma RK, Tewari S. Evaluation of supracrestal gingival tissue after surgical crown lengthening: a 6-month clinical study. J Periodontol. 2013;84(7):934–40. DOI:10.1902/jop.2012.120162.
14. Carneiro VMA, Gomes AMS, Marinho MU, de Melo GS, Kasabji F, An T, et al. Dental and periodontal dimensions stability after esthetic clinical crown lengthening surgery: a 12-month clinical study. Clin Oral Investig. 2024;28(1):76. DOI:10.1007/s00784-023-05458-5.
15. Penmetsa GS, Srividya I, Raju MAKV, Lahari K, Ramaraju AV, Mohana K. Crown lengthening by conventional diode laser and blue laser: a randomised clinical trial. J Clin Diagn Res. 2024;18(3):ZC25–ZC28. DOI:10.7860/JCDR/2024/64200.19214.
16. Wicaksono A, Masulili SLC. Biologic width considerations in crown lengthening surgical procedures: a case report. In: Proceedings of the 11th International Dentistry Scientific Meeting (IDSM 2017). Paris: Atlantis Press; 2018. p. 336–341. DOI:10.2991/idsm-17.2018.45.
17. Newman MG, Takei H, Klokkevold PR, Carranza FA. Newman and Carranza’s Clinical Periodontology. 14th ed. Philadelphia: Elsevier Health Sciences; 2024. p. 62–155.
18. Ferreira CF, Magalhães EB, Zini B. Esthetic crown lengthening and minimally invasive laminate veneers to resolve altered passive eruption. Case Rep Dent. 2024;2024:8882326. DOI:10.1155/2024/8882326.
19. Lanning SK, Waldrop TC, Gunsolley JC, Maynard JG. Surgical crown lengthening: evaluation of the biological width. J Periodontol. 2003;74(4):468–474. DOI:10.1902/jop.2003.74.4.468.
20. Xenoudi P, Karydis A. Crown lengthening procedures for functional and esthetic purposes. Curr Oral Health Rep. 2019;6:230–236. DOI:10.1007/s40496-019-00229-2.
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