Vertical maxillary excess associated with altered passive eruption: a case report with an interdisciplinary approach

Area of Science:

• Dentistry
• Orthodontics
• Periodontology
• Maxillofacial Surgery

Background:

• A gummy smile, characterized by excessive gingival display, negatively impacts dental aesthetics.
• Altered passive eruption (APE), vertical maxillary excess, and lip dynamics are common contributing factors.
• A comprehensive understanding of these factors is crucial for effective treatment planning.

Observation:

• A 31-year-old female patient presented with a gummy smile and dissatisfaction with her tooth aesthetics.
• Clinical examination revealed a long face, retruded chin, protruded maxillary incisors, and significant gingival display indicative of APE.
• The patient had no significant medical history and good general health.

Findings:

• A multidisciplinary treatment plan was implemented, integrating orthodontics and maxillofacial surgery.
• Periodontal surgery, specifically esthetic crown lengthening, was performed as a key component of the treatment sequence.
• This combined approach effectively addressed the complex factors contributing to the patient's gummy smile.

Implications:

• Multidisciplinary treatment is effective for managing complex gummy smile cases associated with APE.
• Combining orthodontic, surgical, and periodontal interventions can achieve significant esthetic improvements.
• Esthetic crown lengthening plays a vital role in correcting gingival display issues in conjunction with other procedures.