The use of mucoperiosteal flap and osteotomy for the treatment of gummy smile: a case report

ABSTRACT Currently the search for aesthetic procedures has increased significantly in dentistry, with the aim of achieving a more harmonious and symmetrical smile. Among the most common aesthetic changes is the gummy smile, which can affect the individual’s self-esteem as it is outside the typical standards of a “perfect” smile. Excessive gingival display is primarily genetic, most frequently affecting women in the second decade of life and patients submitted to orthodontic treatment. Among the main ethiological factors is altered passive eruption, a phenomenon where there is a lack of apical migration of periodontal tissues during the end of tooth eruption, which gives the dental element the appearance of being shortened, affecting the aesthetics of the smile. The aim of this paper is to demonstrate, through a case report, the treatment of gummy smile caused by altered passive eruption using the technique of mucoperiosteal flap surgery with internal bevel incisions associated with ostectomy. After the procedure, we obtained a greater exposure of the anatomical crown elements, correcting the appearance of a gummy smile and promoting aesthetics. After a 90-days follow up, the results were stable, concluding that periodontal surgical procedures are a viable option for gummy smile correction, however, the clinician should be aware how to choose and perform the correct technique for each patient.