PDF: Interdisciplinary treatment of patient with Gummy Smile. Case report

A smile is the most common facial expression to display satisfaction, joy or happiness.

Some physiological and/or pathological conditions result in a displeasing excessive exposition of the gums. This alteration bears a negative repercussion on the individual's appearance since it alters the spontaneity of facial expression.

In our times, patients seek aesthetic dental treatments, to this end, new surgical and prosthetic techniques have been developed with the purpose of achieving desired results.

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Aesthetic dentistry is not only limited to restoration of damaged or absent teeth, it is also geared to prevention and reconstruction of adjacent soft tissue architecture. In order to achieve aesthetic results, many cases require inter-disciplinary treatment combining several procedures. In those cases where aesthetics are involved, surgical alterations of the dental-gingival system can be carried out so as to create an appropriate situation, especially in gummy smile cases.

Determination of gummy smiles causes is of paramount importance. A mistake at this stage could elicit unsatisfactory results as well as complications such as root exposition.

Etiology of excessive gum exposition of gummy smile can be: 1)Short lip length, 2) Excessive lip activity, 3) Length of short clinical crown, 4) Altered passive eruption, 5) Dental-alveolar extrusion, 6) Excessive maxillary vertical dimension.

In order to define the concept of altered passive eruption, we must first review the concepts of eruption process: active eruption is the tooth's occlusal movement up to the point when it reaches its antagonist. Passive eruption features the apical displacement of the dentogingival junction when the tooth reaches its antagonist, the gingival sulcus and the junction epithelium are over the enamel and the clinical crown corresponds to approximately 2/3 of the anatomical crown.

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