Background: Excessive gingival display, or “gummy smile,” occurs in up to 14% of adults and is associated with lip hyperactivity, dentoalveolar extrusion, or vertical maxillary excess. Botulinum toxin A (BTA) has emerged as a minimally invasive therapeutic option, but protocols vary widely and long-term data are limited. Objectives: To critically evaluate the current literature on BTA in gummy smile management, focusing on classification systems, injection techniques, efficacy, safety, and comparative outcomes against conventional surgical and orthodontic treatments. Methods: A narrative review was performed using PubMed, MEDLINE, and Scopus (2000-2023) with the terms “gummy smile,” “excessive gingival display,” and “botulinum toxin.” Clinical studies, case series, and reviews addressing BTA use were included. Data were synthesized into thematic categories. Results: BTA consistently reduced gingival exposure by 3 to 5 mm, with effects lasting 4 to 6 months. Three main injection strategies were identified: single-point (Yonsei), multi-point, and orbicularis oris (“lip flip”). Reported complications were rare and transient (mild asymmetry, lip weakness). Standardized protocols were lacking, with heterogeneity in dosing (2-5 units per site) and injection depth. Comparative studies suggested BTA is less durable than surgical approaches but offers superior patient acceptability and safety for mild to moderate cases. Conclusion: BTA provides reproducible, temporary improvement in gummy smiles with high safety and satisfaction rates. However, absence of consensus on optimal technique and limited long-term evidence highlight the need for standardized protocols and prospective multicenter studies.

The aesthetic qualities of a smile play a crucial role in social interactions, affecting an individual's perceived attractiveness and emotional communication. This study investigated the relationship between smile aesthetics and oral health-related quality of life (OHRQoL) among Chinese college students. This cross-sectional study recruited 220 college students in China using convenience sampling. Frontal smile images were obtained from each participant to evaluate the Smile Index, Gingival Display, visible teeth count during smiling, and buccal corridor ratio. The psychosocial impact of the dental aesthetics questionnaire and oral health impact profile-14 were used to evaluate the OHRQoL of the participants. Correlations were observed between the number of visible maxillary teeth and self-assurance in dental appearance (R = 0.158, P = .026), as well as between the width of the buccal corridor and its influence on social perceptions (R = 0.149, P = .149 for social impact; R = 0.161, P = .023 for oral health impact profile-14). In contrast, a negative correlation was observed between the buccal corridor width and dental self-assurance (r = -0.156, P = .027), while the index for gingival exposure exhibited a robust negative relationship with concerns related to aesthetics (r = -0.185, P = .009). The aesthetics of smiles appear to be related to OHRQoL among college students, highlighting the crucial role of aesthetic factors in orthodontic interventions. These results emphasize the necessity of a holistic dental care approach that integrates both functional and aesthetic aspects of oral health.

Gummy smile (GS), defined as excessive gingival display, compromises facial harmony and self-confidence. Traditional treatments, including orthognathic surgery, botulinum toxin (BTX-A), and lip repositioning, carry limitations in invasiveness, durability, or adaptability. Micro-Autologous Fat Transplantation (MAFT) presents a minimally invasive alternative by volumizing the upper lip and modulating perioral biomechanics. A retrospective study was conducted on 52 patients (mean age: 43.4 years; 92.3% female) who underwent MAFT for GS correction between 2014 and 2023. Fat was harvested, purified, and micro-injected using the MAFT-GUN® into the nasolabial groove, ergotrid, and upper lip. Gingival exposure was measured at four maxillary incisor regions pre- and postoperatively. Patient satisfaction was assessed via a 5-point Likert scale; mean follow-up was 56.4 months. Mean preoperative gingival exposure (3.31 mm) significantly decreased to -0.82 mm postoperatively (p < 0.00001), with a mean reduction of 4.13 mm. The right central incisor showed the greatest improvement. Satisfaction scores increased from 1.40 to 4.90. Mean injected fat volume was 16.1 mL (SD: 3.4 mL), with a calculated graft weight of 14.8 g. No significant correlation was found between volume and outcome (p > 0.40), suggesting anatomical responsiveness. Only two patients (4%) required minor touch-ups; no major complications occurred. MAFT is a safe, effective, and durable treatment for GS. By harmonizing perioral musculature and preserving dynamic lip movement, it bridges the gap between temporary neuromodulators and invasive surgeries, offering a reproducible, minimally invasive solution with long-term aesthetic and functional benefits.

To assess the influence of varying degrees of gingival display on perception of smile aesthetics judged by orthodontists, dentists and lay people. Cross-sectional study. Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, UK. Three groups of raters comprising 25 orthodontists, 25 dentists and 25 lay people. Videos in increments of 1.5 mm of the final lip position ranging from 3 mm incisal coverage to 7.5 mm of gingival display were produced. Three rater groups assessed the attractiveness of smile videos using a visual analogue scale (VAS). Multiple regression analysis was undertaken, and images were compared using the Tukey HSD method. The intraclass correlation coefficient (ICC) was 0.65% (95% confidence interval 0.59-0.71), indicating moderate intra-rater reliability. The highest ranking for female videos was with 1.5 mm of incisal coverage, with no significant difference between 3 mm of incisal coverage and 3 mm of gingival exposure. For the male videos, the highest ranking was 0 mm of gingival show, with no significant difference between 1.5 mm of incisal coverage and 1.5 mm of gingival exposure. There was a significant drop in the scores with further increase in gingival exposure, with more than 6 mm being rated very low aesthetically. Video rating was not influenced by rater group (female: P = 0.60; male: P = 0.06), rater gender (female: P = 0.17, male: P = 0.74) or rater age (female: P = 0.16, male: P = 0.25). There is a significant difference in the perception of smile aesthetics with varying amounts of gingival show. There is a clear threshold of acceptance up to 3 mm of gingival display for the female videos and 1.5 mm in for the male videos, after which the aesthetics of the smile decline with increments of increasing gingival display. No significant differences were observed in the perception of smile aesthetics with varying amounts of gingival show between orthodontists, dentists and lay people.

BackgroundTo evaluate the impact of the SmileView (SV) simulation on smile esthetic perception and its influence on motivation to undertake orthodontic treatment.MethodsA longitudinal study was conducted with 51 subjects in Madrid, Spain. Participants had an initial smile photo taken (T0) and a simulated image generated by SV (T1). They rated, on a 1–10 scale, the general perception of their smile and specific variables (width, alignment, color, gingival exposure, and shape) at both T0 and T1. Intention to pursue orthodontic treatment was recorded. Data were analyzed with SPSS 28.0.ResultsSmile perception improved significantly postsimulation (T0: 5.84 ± 2.12; T1: 7.00 ± 2.61; p = 0.038), with notable gains in alignment (p < 0.001), color (p = 0.004), and shape (p = 0.008). No significant changes were found for width (p = 0.143) or gingival exposure (p = 0.721). Subjects with negative perception at T1 were influenced mainly by tooth shape (p = 0.033). Those with improved perception were driven by alignment, color, and shape. Intent to undergo orthodontic treatment decreased slightly (49.0%–45.0%). Influenced subjects were mostly women, aged 41, with higher education and socioeconomic status. While alignment, color, and shape influenced decision changes, perceived increase in smile width emerged as the strongest independent predictor of treatment intention.ConclusionSV improves smile perception but has limited influence on treatment motivation without clinical guidance.

To clinically evaluate the effect of the application of a Zirconia biovolume combined with surgical crown lengthening in patients with altered passive eruption, vertical maxillary excess, and excessive gingival display. Three systemically healthy patients (two female, one male) presenting altered passive eruption (APE) Type 1 Subtype B with vertical maxillary excess (VME) and gingival display > 5 mm were treated with a protocol consisting in the preparation of a Zirconia biovolume to be applied in the anterior maxilla at the same time of surgical crown lengthening. Intra and extra oral scans were taken, as well as CBCT and printing of stereolithographic models in order to study the cases, plan the fabrication of the biovolume, and plan the surgical crown lengthening. Patients were followed for up to 12 months. Healing was uneventful in all three cases, and all patients were satisfied with the esthetic outcome in terms of surgical crown lengthening, gingival exposure, and lip repositioning. These three cases show how the planning of cases with excessive gingival display, VME, and APE can be treated with a planned surgical procedure that will at the same time solve the problem of gingival exposure and the position and support of the upper lip.

281 - Early Orthopedic Treatment of Vertical Maxillary Excess and Severe Gingival Exposure in a Growing Patient: A Clinical Case Report

Gummy Smile, or excessive gingival display, is a clinical condition characterized by an overexposure of the maxillary gingiva during smiling, typically exceeding 3 mm. Although not pathological, this condition can lead to aesthetic discomfort and negatively impact the patient's self-esteem. In a normal, aesthetically pleasing smile, gingival exposure—defined as the distance between the lower margin of the upper lip and the cervical area of the upper central incisors—should not exceed 1–2 mm.1 Gummy Smile affects approximately 10% of individuals aged 20–30, with a higher prevalence among females.2 This condition has a multifactorial etiology, with each causative factor potentially acting independently or in combination with others, thereby complicating both the clinical presentation and case management.3 The main causes of excessive gingival exposure include: 1. Altered passive eruption (APE) 2. Dentoalveolar extrusion 3. Vertical maxillary excess (VME) 4. Gingival hyperplasia 5. Short upper lip 6. Hypermobility of the upper lip4 This study presents a systematic review of the scientific literature on therapeutic approaches for the treatment of Gummy Smile, offering a qualitative analysis of clinical indications, procedural techniques, aesthetic and functional outcomes, duration of results, post-treatment recovery, possible complications, and patient satisfaction. Based on the emerging evidence, a clinical decision-making algorithm has been developed to guide clinicians in the selection and management of Gummy Smile cases, according to their etiological profile. This algorithm is proposed

Introduction: Smile esthetics are crucial in orthodontics; however, orthodontists, general dentists, and laypersons perceive deviations differently, prompting the need for comparative evaluation. This study explored how these groups assess upper midline discrepancies, gingival display, maxillary cant, reduced upper teeth show, asymmetric upper lip elevation, and chin deviation, aiming to determine their combined impact on smile attractiveness and treatment needs while identifying thresholds for clinical intervention to enhance patient-focused care.Methodology: This cross-sectional study was conducted in the Department of Orthodontics from August 2023 to October 2024. A frontal smile photograph was digitally manipulated to create six series of images (54 images), each with nine variations of upper midline displacement with respect to facial midline (-2 to +2 mm in 0.5 mm increments). Modifications included increased gingival exposure (gumminess), a 5° maxillary cant, reduced upper teeth show, 2 mm asymmetric upper lip elevation, and 2 mm chin deviation. Ninety evaluators (30 orthodontists, 30 general dentists, 30 laypersons) assessed the images using a visual analog scale (VAS) for attractiveness and indicated the need for treatment. Data were analyzed using one-way analysis of variance (ANOVA) for VAS scores and chi-square tests for treatment need, with intra-evaluator reliability assessed using intraclass correlation coefficients.Results: Orthodontists demonstrated significantly higher sensitivity to minor upper midline deviations (-1.0 mm to 0.0 mm), maxillary cant, and asymmetric upper lip elevation compared to general dentists and laypersons (P < 0.05), with significant intergroup differences in perceived treatment need for all conditions except chin deviation at the ideal midline (0.0 mm). As deviations increased beyond 0.5 mm, perceptions converged, becoming statistically indistinguishable (P > 0.05). Orthodontists recommended treatment most frequently (>90% for 1.5-2.0 mm deviations), particularly for chin deviation and upper lip asymmetry, while laypersons showed the lowest treatment need perception (40%-60% No for minor deviations). Increased gingival display and chin deviation amplified the treatment need across groups, with same-side chin and midline deviations less noticeable than opposite-side deviations.Conclusions: Professional expertise significantly influenced the detection of subtle smile deviations, with orthodontists advocating treatment more often than laypersons. These findings emphasize the need for tailored patient communication to align clinical interventions with patient expectations and enhance patient-centered orthodontic outcomes.

Background: A gummy smile (excessive gingival display) is a common aesthetic concern that disrupts the visual harmony between teeth, gingiva, and lips. Its etiology may be gingival, muscular, or skeletal. While multiple treatment modalities exist, selecting the optimal plan depends on accurate diagnosis of the underlying cause. Objective: To evaluate the effectiveness of combining gingivectomy and botulinum toxin injections in managing gummy smiles caused by altered passive eruption and hyperactivity of the upper lip elevator muscles, and to compare the outcomes with those reported in the literature. Materials and Methods: Diagnosis was established through clinical examination, panoramic radiography, and gingival measurements. An external bevel gingivectomy was performed without osseous recontouring, followed by botulinum toxin injections (2 units per side) at the Y-point. Outcomes were assessed in terms of aesthetic improvement, stability, and patient satisfaction. Results: The combined approach reduced gingival exposure and improved the crown-to-gingiva ratio, achieving high patient satisfaction. Findings were consistent with studies supporting the integration of surgery and botulinum toxin in multi-factorial cases. Botulinum toxin provided rapid but temporary improvement (4–6 months), while gingivectomy offered longer-lasting results in gingival-related cases. Conclusion: The combination of gingivectomy and botulinum toxin injections is an effective treatment option for gummy smiles of mixed etiology, provided that precise diagnosis and clear indications for each procedure are established. A multidisciplinary approach and well-defined diagnostic algorithms are recommended to ensure optimal aesthetic and functional outcomes.

Background: A gummy smile (excessive gingival display) is a common aesthetic concern that disrupts the visual harmony between teeth, gingiva, and lips. Its etiology may be gingival, muscular, or skeletal. While multiple treatment modalities exist, selecting the optimal plan depends on accurate diagnosis of the underlying cause. Objective: To evaluate the effectiveness of combining gingivectomy and botulinum toxin injections in managing gummy smiles caused by altered passive eruption and hyperactivity of the upper lip elevator muscles, and to compare the outcomes with those reported in the literature. Materials and Methods: Diagnosis was established through clinical examination, panoramic radiography, and gingival measurements. An external bevel gingivectomy was performed without osseous recontouring, followed by botulinum toxin injections (2 units per side) at the Y-point. Outcomes were assessed in terms of aesthetic improvement, stability, and patient satisfaction. Results: The combined approach reduced gingival exposure and improved the crown-to-gingiva ratio, achieving high patient satisfaction. Findings were consistent with studies supporting the integration of surgery and botulinum toxin in multi-factorial cases. Botulinum toxin provided rapid but temporary improvement (4–6 months), while gingivectomy offered longer-lasting results in gingival-related cases. Conclusion: The combination of gingivectomy and botulinum toxin injections is an effective treatment option for gummy smiles of mixed etiology, provided that precise diagnosis and clear indications for each procedure are established. A multidisciplinary approach and well-defined diagnostic algorithms are recommended to ensure optimal aesthetic and functional outcomes.

Background and Aim: Smile esthetics play a crucial role in self-perception and social interactions. Digital tools have advanced smile analysis, but their reliability remains under investigation. This study evaluates the intra- and interoperative reliability of Makhter facial analysis software (FAS) in assessing smile components using standardized digital photographs and videographic recordings. Materials and Methods: A total of 130 participants (65 males and 65 females) were selected based on specific inclusion criteria. Standardized frontal smile photographs and video clips were captured following strict imaging protocols. The Makhter FAS software was used to analyze 11 key smile parameters, including outer commissure width, buccal corridor width, upper and lower incisal display, and gingival display. Statistical analysis, including intraclass correlation coefficients (ICCs) and paired t -tests, assessed software reliability. Results: The intraoperator reliability for measured parameters ranged from 0.650 to 0.983, with gingival display exhibiting the highest ICC (0.983). Interoperator reliability values ranged between 0.620 and 0.969, demonstrating strong agreement. Females exhibited greater upper incisal display and gingival exposure, while males had broader buccal corridors. Dynamic videographic assessments provided higher accuracy than static photographic evaluations. Conclusion: Makhter FAS demonstrated high reliability and reproducibility in digital smile analysis. Dynamic assessments yielded more precise measurements, underscoring their importance in orthodontic diagnostics. These findings reinforce the clinical utility of digital smile analysis software in enhancing orthodontic treatment planning.

Physiological pigmentation of the oral mucosa appears as multifocal or widespread melanin pigmentation, varying in intensity across different ethnic groups (Cicek, 2003) [4]. The main factors influencing gingival color include the thickness of the gingival epithelium, the quantity and size of blood vessels, the degree of keratinization, and the presence of various pigments. Melanin, a brown pigment, is the most common endogenous pigment responsible for natural gingival pigmentation. The gingiva is the most frequently pigmented part of the oral mucosa. Melanin pigmentation occurs in the basal layer of the gingival epithelium, where melanin granules produced by melanoblasts become interspersed among epithelial cells. While melanin hyperpigmentation of the gingiva does not pose any medical risk, many individuals perceive dark gums as aesthetically displeasing. This concern becomes more prominent in those with a "gummy smile" or excessive gingival exposure during smiling. Gingival depigmentation is a periodontal plastic surgery procedure aimed at eliminating or reducing gingival hyperpigmentation through various techniques. This procedure is typically performed based on the individual's aesthetic concerns rather than clinical necessity. Multiple depigmentation methods are available, including chemical agents like phenol, alcohol, and ascorbic acid; conventional techniques such as scalpel surgery, gingival abrasion, and free gingival grafting; as well as advanced methods like acellular dermal matrix allografts, laser depigmentation, electrosurgery, cryosurgery, and radiosurgery. The current case report presents a straightforward and efficient surgical depigmentation technique that delivers aesthetically pleasing outcomes and ensures patient satisfaction without the need for advanced instruments or equipment.

This paper aims to describe the ideal relationship between lips and teeth as 2 critical facial features to guide young doctors keen on lip augmentation. The literature survey was performed in PubMed, EBSCO, UpToDate, Proquest Central databases of Kirikkale University, and Google and Google Scholar databases. There is a relationship between the visibility of teeth and the amount of tooth show and its attractiveness, but only if the gingival exposure is within the standard setting and between the upper central incisor tips if the buccal corridor is not exceeding 1mm. A smile's visual expression and aesthetics do not simply involve the lips alone. Facial esthetics result from harmony between several minor factors, the combination of which determines the patient's overall appearance. For instance, when laughing with an open mouth, a person's teeth become visible. The need for lip enhancement is based on the patient's aesthetic goals, infrastructural tooth position/visibility, and stage of facial aging. To help achieve lip augmentation goals, facial aesthetic subunits, soft-tissue patterns, and bony landmarks should be considered. Lip augmentation is typically performed by adding volume through various means and materials. The authors must offer essential new data on the relationship between lip augmentation and teeth visibility. A given upper lip enhancement will make the maxillary incisors visible to a greater or lesser extent. However, there is limited research on what constitutes a prioritized single most crucial factor in promoting maxillary incisor visibility.

Gummy smile is a condition characterized by excessive exposure of the gums during smiling. The demand for treatment for this condition has increased in recent years, and numerous techniques have been reported to treat gummy smile, such as gingivectomy, orthognathic surgery, lip repositioning surgery, and botulinum toxin injections. The objective of the work was to answer the guiding question: “What is the effect of botulinum toxin type A in the management of excessive gingival exposure – gummy smile?”. The databases Pubmed, Scielo and LILACS were used. The search was carried out in an advanced form, considering the descriptors: botulinum toxin, gummy smile, gum, botox and minimally invasive procedures. The inclusion criteria used were complete articles available in full, in the listed databases, published in the last 5 years in Portuguese, English and Spanish languages. Off-topic publications; in vitro and animal studies, literature reviews, theses, monographs and book chapters were excluded. 143 articles were retrieved, of which 77 were excluded due to duplication. After analyzing the titles and abstracts, 17 works were selected. At the end of the selection, 11 articles were included after reading the full text. It was concluded that the application of botulinum toxin is a safe and effective procedure for managing excessive gummy smile. It presented low rates of complications and high levels of satisfaction among patients. However, the patient must be aware that the clinical effect of botulinum toxin is temporary and requires periodic touch-ups to maintain the desired result. Keywords: Botulinum toxin. Gummy smile. Gingiva. Botox. Minimally invasive procedures.

Abstract The smile has a very significant role in the life of an individual for a variety of reasons, including their health, psychological well-being, and social and emotional connections. Hence, it is of utmost important to understand the factors that help or harm the attractiveness of a smile to create an attractive smile. Excessive gingival display (EGD) or gummy smile is considered an unesthetic factor before dental professional and common public. This case report describes a case of EGD in an individual in his twenties who was in the completion stage of his orthodontic treatment. Patient complained of unsatisfactory smile due to his gingival exposure. On clinical examination, the patient had an EGD of 8 mm. The patient was not willing for orthodontic management; hence, the patient was managed by a less invasive approach using modified lip repositioning technique. The patient was satisfied with the overall treatment outcome and experience.

Excessive gingival display (EGD), commonly known as a gummy smile (GS), is a cosmetic concern that involves exposing a significant area of gum tissue during a smile, rendering it unaesthetic. Gingival exposure greater than 3 mm is deemed aesthetically displeasing and often necessitates treatment to mask the gummy smile. The causes of EGD are multifactorial, including altered passive eruption (APE), hypermobile upper lip (HUL), short lip length, increased vertical maxillary component, gingival hyperplasia, dentoalveolar extrusion, and more. As each aetiology requires different treatment modalities, patients with EGD should be thoroughly evaluated and individualized treatment plans should be developed. Lip repositioning surgery (LRS) is a minimally invasive conservative technique that decreases gummy smiles in patients with increased lip mobility and mild vertical maxillary excess. If the aetiology is multifactorial, LRS can be combined with other treatment modalities such as crown lengthening and gingivectomy for improved aesthetic outcomes. This review discusses the recent modifications and current techniques that have evolved from traditional LRS.

An aesthetically pleasing smile results from the combination of several factors, such as the position, size, shape, and color of the teeth, as well as the exposure and characteristics of the gingival tissue. When evaluating the gingival tissue in a smile, several important factors must be considered: excessive vertical growth of the maxilla, reduced length of the upper lip, excessive contraction of the upper lip, and disproportion between the length and width of the clinical crown of the anterior teeth. A minimally invasive approach that can be used as a complement to dental treatment is the application of botulinum toxin, a neurotoxin produced by the anaerobic bacterium Clostridium botulinum. This toxin blocks the release of acetylcholine in the presynaptic vesicles of neuromuscular junctions, inhibiting muscle contraction. The aim of this literature review was to analyze the use of botulinum toxin type A (BTX-A) in the management of gummy smile. The search was conducted in the databases Google Scholar, PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO). The descriptors used for the search were "botulinum toxin," "gingiva," "periodontology," and "dental aesthetics," combined using the boolean operators AND and OR. Although the evidence demonstrates favorable results, the use of botulinum toxin to correct gummy smile has limitations. It is a temporary solution, and patients should be informed about the need for periodic reapplications and the potential side effects, such as facial asymmetries. The reviewed studies indicate that this technique is particularly effective in cases of gummy smile resulting from hyperactivity of the upper lip elevator muscle, providing a significant reduction in gingival exposure, with results lasting up to 12 weeks. The combination of different therapeutic approaches, along with a careful evaluation of the causes of gummy smile, allows dental professionals to offer more integrated and personalized solutions for each patient.

Background: The aim of the present survey is to understand the subjective preference of non-dental professionals (NDP’s) with five parameters which can be modified by an orthodontist and compare it with the perception of orthodontists and orthodontic postgraduates. Four standard photographs of facial esthetics of 2 young woman were digitally modified using software and divided into 5 parameters (Asymmetry, nasolabial angle, smile, vertical facial height, profile). NDP’s differ from the subjective preference of orthodontist and postgraduates respectively. Methods: A picture-based questionnaire survey edited in Adobe software was conducted for all the groups using google forms. Survey rendered 418 responses overall. The overall statistics was done using SPSS 22.0 version. Results: NDP’s prefer 0 mm of facial asymmetry, 80° nasolabial angle, 0 and 2 mm of gingival exposure during smile, 1:1.14 ratio of middle to lower 1/3rd, 10° of convexity angle. Conclusion: NDP’s, orthodontist and orthodontic postgraduates differ in their perception of facial esthetics.

A gummy smile is the visualization of more than 3 mm of gingiva above the maxillary incisors. This study aimed to evaluate the long-term effects on aesthetics and patient satisfaction of a new hyaluronic acid infiltration technique in reducing the gummy smile. Fifty patients with gummy smiles were treated using hyaluronic acid infiltration points by applying 0.1 mL per injection at specific points. Post-treatment evaluations were performed one week, one month, three months, six months, and 12 months later. A questionnaire assessed patient satisfaction, willingness to recommend the treatment, and side effects (pain and bruising during and after treatment). An average reduction of 2.5 mm in gingival exposure during smiling was observed. After one week, the reduction was constant. At six months, 40% of the original gingival exposure was recovered, and recovery was complete at 12 months. Patient satisfaction was 82.1%, and 100% of patients would recommend the treatment. Bruising, swelling, and pain decreased to 0% from the first month. In conclusion, this technique is a safe and effective option to improve the smile's appearance with minimal complications.