Pink-White Esthetic Optimization in Excessive Gingival Display Using Crown Lengthening and Direct Composite Veneering
Abstract
An esthetic smile plays a pivotal role in enhancing patient confidence and social well-being. Smile esthetics are influenced by multiple factors, including maxillary anterior tooth morphology, lip length and mobility, periodontal health, and the degree of gingival display. Short clinical crowns associated with excessive gingival display are generally perceived as unesthetic and frequently require esthetic crown lengthening. Altered active eruption (AAE) and altered passive eruption (APE) represent common etiologic factors in such presentations. Management typically involves gingivectomy with or without osseous resection while ensuring adequate space for the supracrestal tissue attachment. Violation of the supracrestal tissue attachment may lead to gingival inflammation, recession, and alveolar bone loss; therefore, a postoperative healing period of 3-6 months is recommended to allow soft tissue maturation and assessment of marginal gingival stability. Conventionally, restorative rehabilitation following esthetic crown lengthening has relied on invasive approaches, including porcelain-fused-to-metal crowns, all-ceramic crowns, and porcelain veneers. However, evidence supporting minimally invasive or noninvasive restorative modalities-particularly direct composite restorations-remains limited. This case series is aimed at describing a minimally invasive restorative protocol utilizing direct nanocomposite veneering following esthetic crown lengthening and soft tissue maturation…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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