Innovative Management of Gummy Smile With Direct Composite Veneers Guided by the Crescent Metal Matrix: A Clinical Case

A gingival (gummy) smile is a common esthetic concern that can affect facial harmony and patient confidence. Its etiology may involve altered passive eruption, hyperactive lip musculature, vertical maxillary excess, or dentoalveolar factors, making accurate diagnosis essential for successful management. This case report presents a minimally invasive approach for gingival smile correction and anterior esthetic rehabilitation using a novel pre-contoured metal matrix system in combination with direct composite restorations. A 28-year-old patient presented with excessive gingival display and small anterior teeth, compounded by existing crowns on the maxillary central incisors. Treatment involved precise gingival trimming guided by the metal matrix to achieve optimal contour and symmetry, followed by the restoration of teeth #11 and #21 with customized composite crowns reinforced with a fiber post. Composite veneers were then applied to enhance overall esthetics. The procedure was complemented by topical application of a corticosteroid oral paste to promote healing and comfort. At three-month and subsequent follow-ups, the gingival tissues exhibited healthy contour and stability, and the restorations demonstrated excellent esthetic integration and function. The described approach highlights the effectiveness of integrating innovative matrix-guided contouring with conservative restorative techniques to achieve predictable esthetic and periodontal outcomes in the management of a gingival smile.