Effect of aesthetic crown lengthening on life quality and self‐esteem: 2‐year study

BACKGROUND: A gummy smile can result from several factors, often leading to a disharmonious appearance and causing physical and psychological discomfort for the patient. This study aimed to evaluate changes in self-esteem and quality of life for patients, as well as the recidivism rate, following aesthetic crown lengthening (ACL) surgery. METHODS: Twenty-two periodontally healthy patients who expressed interest in undergoing ACL and met the procedural indications were selected. Before surgery, at 30 days, and 2 years postoperatively, the Oral Health Impact Profile - 14 items (OHIP-14) and the Rosenberg Self-Esteem Scale were used to assess patients' perceptions of quality of life and self-esteem. Crow dimensions, gingival phenotype, and the recidivism rate were assessed. RESULTS: ACL significantly improved the psychosocial parameters of patients (p < 0.05). Both self-esteem and quality of life showed improvement 30 days post-surgery (p = 0.02 and 0.00024, respectively). After 2 years, further improvements were observed in the self-esteem index compared to the 30-day results (from 11 [interquartile range {IQR}: 8.0-14.0] to 14 [IQR:12-15, p < 0.05]) and in the OHIP score (from 19 [IQR:14-27] to 6 [IQR: 0.0-8.0]). The clinical crown length established 30 days after surgery remained stable after 2 years (0.82 ± 0.11). CONCLUSIONS: ACL can enhance patients' quality of life and self-esteem, serving as a valuable procedure in aesthetic periodontics. PLAIN LANGUAGE SUMMARY: A "gummy smile," where too much gum tissue shows when a person smiles, can affect both appearance and confidence. This study looked at whether aesthetic crown lengthening surgery (a procedure that reshapes the gums and exposes more of the teeth) could improve how people feel about themselves and their daily lives. We followed 22 patients who underwent this surgery and measured their self-esteem and quality of life before the procedure, 1 month later, and again 2 years after the procedure. Results showed that patients felt noticeably better about their smiles and overall quality of life just 1 month after surgery. Even more encouraging, these benefits continued to grow over the course of 2 years, with patients reporting higher self-esteem and fewer problems related to their oral health. Importantly, the changes achieved by the surgery-such as the new tooth and gum proportions-remained stable, with no return of the gummy smile. These findings suggest that crown lengthening is not only an effective and lasting solution for improving the appearance of a gummy smile but also has meaningful, long-term benefits for patients' confidence and well-being.