Gingival Contouring and Smile Makeover Through Digital Planning and 3D Guidance

Background: Gingivectomy plays a vital role in restorative dentistry, especially for patients with uneven gingival architecture. Traditional techniques often present challenges in achieving precision and symmetry. This case report demonstrates the effectiveness of a fully digital workflow for planning and performing gingivectomy, aiming to improve clinical accuracy and esthetic outcomes. A mock-up was also fabricated post-surgery to visualize the expected final result and assist in guiding subsequent treatment. Methods: A comprehensive digital workflow was implemented, starting with an Artificial Intelligence (AI)-based smile simulation to preview the esthetic outcome. A digital smile design was used to fabricate a combined tooth and gingival reduction guide through Computer-Aided Design and Manufacturing (CAD/CAM). The guide was stored under controlled conditions to maintain dimensional stability. Provisional restorations were milled from Mono Polymethylmethacrylate (PMMA), a dedicated CAD/CAM temporary material and also served as the mock-up. Laser-assisted gingivectomy was then performed using the three-Dimensional (3D)-printed guide, followed by placement of the provisional restorations. Results: The digital workflow enabled precise gingival contouring, accurate guide fit and harmonious integration between gingival margins and restorative contours. The mock-up provided clear visualization of the esthetic improvements, with minimal invasiveness and high patient satisfaction. The PMMA provisionals exhibited excellent esthetics and biological compatibility. Conclusion: This case underscores the advantages of integrating AI-driven planning and CAD/CAM technology in periodontal and restorative dentistry. The digital approach facilitated precise surgical execution, predictable outcomes, and effective communication with the patient. The high-quality mock-up not only enhanced patient acceptance but also served as a reliable template for subsequent esthetic treatment phases.