The case shown here is of a 54 year-old female patient presenting an excess of gingival display commonly referred to as a “gummy smile”.

The “gummy smile” is a condition in which an excess of gingiva (gum) is shown when you smile. This condition can be caused by a variety of factors,  but the problem here was related to a phenomenon known as “Altered Passive Eruption” (APE) in which excessive amounts of gingiva overlapp the enamel (tooth) limits during tooth eruption resulting in a large quantity of gingiva and a clinical crown appearance that gives the sensation of “short” teeth.

The management of these cases is surgical and in this case consisted of a procedure in which the teeth are lengthened by a technique called the “apically positioned flap”. The patient was highly compliant with treatment and strictly followed both pre- and post-operative instructions given. The  post-operative results show a much more pleasant, natural appearing smile. The results obtained with this technique are maintained in the long-term.

Technique

The “Apically Positioned Flap”

Read more about it here.

Objectives

  1. Obtain an increase in the length of the clinical crowns
  2. Re-establish the correct biologic width
  3. Improve the aesthetics of the smile

Skills involved

  • Differential diagnosis of excess of gingival display or “gummy smile”
  • Knowledge on surgical periodontal techniques
  • Management of minimally invasive surgical techniques