Abstract
Excessive gingival display is a common clinical presentation that often requires surgical intervention. This report is for a patient for whom esthetic crown lengthening is indicated due to altered passive eruption. Cone beam computed tomography (CBCT) scan and an intraoral scan were used to design and print a single surgical guide which provided a reference for both gingivectomy and osteoectomy. A satisfactory outcome was obtained 6 months after surgery. The present technique provided a simplified method of generating a surgical guide with predictable results by relying on the existing tooth anatomy rather than diagnostic waxing. This technique is particularly useful when crowns or veneers are not indicated.
Highlights
Excessive gingival display, which can be due to altered passive eruption (APE) or gingival enlargement, results in short clinical crowns; this is a cause of common esthetic concern for many patients
The decision whether to perform bone resection is largely dependent on the location of the alveolar bone crest in relation to the cementoenamel junction
Surgical guides are usually fabricated as a reference for crown lengthening procedures, especially when anterior teeth are involved
Summary
Excessive gingival display, which can be due to altered passive eruption (APE) or gingival enlargement, results in short clinical crowns; this is a cause of common esthetic concern for many patients. Gingivectomy or esthetic crown lengthening with bone resection is often required to increase the clinical crown length and achieve acceptable esthetic outcomes [1]. The decision whether to perform bone resection is largely dependent on the location of the alveolar bone crest in relation to the cementoenamel junction. If the bone crest is at, or coronal to, the cementoenamel junction, osseous resective surgery is indicated [2]. In order to locate the bone crest, bone sounding and periapical radiograph assessments are typically performed [3,4] these methods may be challenging and could provide inaccurate assessments [5]. Cone beam computed tomography (CBCT) has been suggested as a precise and reliable alternative approach for diagnosing APE [6]
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