Aesthetic Crown Lengthening for Gummy Smile: A Case Report

doi:10.13701/j.cnki.kqyxyj.2025.09.016

Abstract

Abstract: This article reports a case of altered passive eruption (APE) characterized by short clinical crowns, aberrant gingival margin positions, and noticeable excessive gingival display (gummy smile). A crown lengthening procedure was performed to reestablish the biological width and improve the crown-to-gingiva aesthetic proportions. A 6-month follow-up confirmed a clinically satisfactory and aesthetically pleasing outcome.

Key words: altered passive eruption, crown lengthening, surgical treatment

ZHOU Chunxiang, CAO Zhengguo, ZHANG Huihui. Aesthetic Crown Lengthening for Gummy Smile: A Case Report[J]. Journal of Oral Science Research, 2025, 41(9): 824-828.

References

[1] Maizoub Zeina AK, Romanos A. Cordioli G. Crown lengthening procedures: a literature review[J].Seminar Orthod, 2014, 20(3):188-207.
[2] Hempton TJ, Dominici JT. Contemporary crown-lengthening therapy: a review[J]. J Am Dent Assoc, 2010, 141(6):647-655.
[3] Coslet JG, Vanarsdall R, Weisgold A. Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult[J]. Alpha Omegan, 1977, 70(3):24-28.
[4] Mele M, Felice P, Sharma P, et al. Esthetic treatment of altered passive eruption[J]. Periodontol 2000, 2018, 77(1):65-83.
[5] Ong M, Tseng SC, Wang HL. Crown lengthening revisited[J]. Clin Adv Periodontics, 2017, 1(3):233-239.
[6] Venugopal A, Manzano P, Ahmed F, et al. Gummy smiles: Etiologies, diagnoses & formulating a clinically effective treatment protocol[J]. Semin Orthod, 2024, 30(5):482-501.
[7] Kahn S, Rodrigues WJdPR, Dias AT, et al. Crown lengthening surgery in the Esthetic Area for optimized Results: A review with surgical recommendations[J]. Surgeries, 2024, 5(4):1043-1055.
[8] Deas DE, Moritz AJ, McDonnell HT, et al. Osseous surgery for crown lengthening: a 6-month clinical study[J]. J Periodontol, 2004, 75(9):1288-1294.
[9] 伍妍,吴中兴.露龈微笑病因的研究进展[J].口腔颌面外科杂志,2009,19(4):292-295.
[10] Alpiste-Illueca F. Morphology and dimensions of the dentogingival unit in the altered passive eruption[J]. Med Oral Patol Oral Cir Bucal, 2012, 17(5):e814-e820.
[11] Weinberg MA, Eskow RN. An overview of delayed passive eruption[J]. Compend Contin Educ Dent, 2000, 21(6):511-514, 516, 518 passim; quiz 522.
[12] Batista EL Jr, Moreira CC, Batista FC, et al. Altered passive eruption diagnosis and treatment: a cone beam computed tomography-based reappraisal of the condition[J]. J Clin Periodontol, 2012, 39(11):1089-1096.
[13] Cairo F, Graziani F, Franchi L, et al. Periodontal plastic surgery to improve aesthetics in patients with altered passive eruption/gummy smile: a case series study[J]. Int J Dent, 2012, 2012:837658.
[14] Camargo PM, Melnick PR, Camargo LM. Clinical crown lengthening in the esthetic zone[J]. J Calif Dent Assoc, 2007, 35(7):487-498.
[15] Alhumaidan A, Alqahtani A, al-Qarni F. 3D-printed surgical guide for crown lengthening based on cone beam computed tomography measurements: A clinical report with 6 months follow up[J]. Appl Sci, 2020, 10:5697.
[16] Borham E, Abuel-Ela HA, Mohamed IS, et al. Treatment of excessive gingival display using conventional esthetic crown lengthening versus computer guided esthetic crown lengthening: (a randomized clinical trial)[J]. BMC Oral Health, 2024, 24(1):317.
[17] Jurado CA, Parachuru V, Villalobos Tinoco J, et al. Diagnostic mock-up as a surgical reduction guide for crown lengthening: Technique description and case report[J]. Medicina (Kaunas), 2022, 58(10):1360.
[18] Chu SJ, Tarnow DP, Tan JH, et al. Papilla proportions in the maxillary anterior dentition[J]. Int J Periodontics Restorative Dent, 2009, 29(4):385-393.
[19] Fletcher P. Biologic rationale of esthetic crown lengthening using innovative proportion gauges[J]. Int J Periodontics Restorative Dent, 2011, 31(5): 523-532.
[20] Malli P, Kateel SB, K A, et al. An assessment of the accuracy of recurring esthetic dental proportion: An in vivo comparative analysis of maxillary anterior teeth proportion with Chu's gauge and custom-made calipers[J]. Cureus, 2023, 15(11):e49713.