Digital Simulation and Clinical Validation of a Novel Open-Source-Based Workflow for 3D-Printed Surgical Guide...

This case report introduces a novel open-source-based digital workflow for esthetic crown lengthening (ECL) utilizing a customized 3D-printed surgical guide. A 35-year-old female patient with excessive gingival display underwent ECL planned through an integrated model combining intraoral scanning and cone-beam computed tomography data. Virtual simulation enabled precise measurement of periodontal structures, and a surgical guide termed the gingivectomy with osseous resective surgery template (GORST) was designed using free software. The GORST integrated a gingivectomy guiding line and bone reduction windows, allowing soft and hard tissue management in a single stent. Surgical execution followed the preoperative plan accurately, resulting in significant esthetic improvement with elongated clinical crowns, symmetrical gingival contours, and no postoperative hypersensitivity. This workflow offers a cost-effective, predictable approach for esthetic periodontal surgery while also reducing the surgical time. Further clinical studies are warranted to validate its broader applicability.