Treatment for Altered Passive Eruption: A 30-Month Follow-Up Case Study With a Digital Workflow Approach

Digital workflow has become an important tool for surgical dentistry and helps clinicians plan and treat several conditions. The excessive gingival display, also known as a gummy smile, is one of the conditions where digital planning and 3D-printed surgical guides bring benefits to both patients and surgeons, by increasing the accuracy of the execution, as close as possible, to the proposed planning. The objective of this case report is to show a case of altered passive eruption treated with aesthetic crown lengthening with the use of a 3D-printed surgical guide. After the patient accepted the proposed treatment plan, a surgical guide was printed according to the digital planning. The surgery had an initial gingivectomy guided by the 3D-printed guide, and after raising the mucoperiosteal flap, osteotomy was also guided by a 3D-printed guide. After three months, the patient was sent to the prosthodontist to replace a composite veneer on the left upper central incisor, with the margins exposed after the gingival healing. With 30 months of follow-up, the patient presents great margin stability and periodontal health. The use of digital workflow appears to facilitate the predictability of periodontal aesthetic treatments and may have more applicability shortly.