Treatment for an Altered Passive Eruption (APE)

Abstract

Altered Passive Eruption (APE) is a condition where the gingival margin is more incisal or occlusal than the cementoenamel junction. Apart from disrupting the aesthetics of a smile, this condition can also be a risk factor for periodontal disease. APE is characterized by a gummy smile and short-looking teeth. Periodontal crown lengthening surgery is a treatment option that can be given to treat this case. The choice of periodontal crown lengthening surgery procedure must be adjusted based on the APE classification of the patient's case. This case report aims to describe the management of APE type 1A with periodontal crown lengthening surgery through gingivectomy. A 25-year-old female patient came to RSGM UMY with complaint that the gums on the front teeth of the upper jaw seemed large. The patient's general health is good. The results of intraoral examination showed that there were an elevation of the gingiva towards the incisal direction, and the teeth appeared short on 12, 11, 21, and 22. The examination also showed the presence of cretinized gingival tissue that appeared larger vertically on 12, 11, 21, and 22. On radiographic examination, the distance between the cementoenamel junction and the crestal bone is greater than 1 mm. The patient's APE classification was type 1A, hence gingivectomy was performed in this case. In treating APE cases, determining the correct diagnosis and selecting appropriate therapeutic management must be considered according to the patient's case. All therapeutic decisions must be discussed with the patient in order to satisfy their desires