Management of Altered Passive Eruption With Gingivoplasty and Osteoplasty Prior to Esthetic Veneer Rehabilitation

Altered passive eruption is a common esthetic condition characterized by excessive gingival coverage of the anatomical crowns, resulting in short clinical crowns, excessive gingival display, and compromised smile esthetics. This case report describes the management of altered passive eruption in a 27-year-old male patient who presented with hypersensitivity affecting several maxillary anterior teeth, excessive gingival display, and dissatisfaction with the appearance of his smile. The patient reported that these conditions negatively affected his self-confidence in both social and professional settings. Clinical examination revealed short clinical crowns and unfavorable tooth proportions associated with excessive gingival tissue coverage. A treatment plan consisting of surgical smile design with gingivoplasty and osteoplasty was developed to establish appropriate gingival architecture and supracrestal tissue attachment prior to restorative treatment. Following flap elevation and osseous recontouring, favorable healing, improved gingival symmetry, and increased clinical crown length were achieved. After soft tissue maturation, esthetic veneer rehabilitation was completed to optimize tooth proportions and smile harmony. The combination of periodontal surgery and restorative treatment resulted in improved gingival contours and smile esthetics, while the patient reported resolution of the previously reported dental hypersensitivity and satisfaction with the treatment outcome. This case highlights the importance of a multidisciplinary approach in the management of altered passive eruption and illustrates how coordinated periodontal and restorative treatment can contribute to favorable short-term esthetic and clinical outcomes.