Periodontal and restorative integration for managing extreme gummy smiles with lip repositioning flap, crown lengthening, and lithium disilicate veneers: A case report

Abstract

Background

Excessive gingival display, commonly referred to as a gummy smile, has a major impact on facial aesthetics and patient confidence. Addressing this condition often requires a multidisciplinary approach combining periodontal and restorative procedures.

Purpose

This case report intends to demonstrate the efficacy of a comprehensive treatment strategy that included a lip repositioning flap, crown lengthening, and lithium disilicate veneers in achieving esthetic rehabilitation of an extreme gummy smile.

Case

A 29-year-old male patient presented with excessive gingival display and short clinical crowns, resulting in a disharmonious smile. The patient expressed dissatisfaction with her smile aesthetics and sought a minimally invasive yet effective solution.

Case management

The initial evaluation includes clinical and radiographic assessments to identify gingival biotype, crown-to-root ratio, and amount of gingival excess. A lip repositioning flap was performed to optimize gingival levels, followed by crown lengthening to expose adequate tooth structure for veneering. Lithium disilicate veneers were created utilizing a digital approach to improve precision and aesthetics. The treatment lasted six months, which ensured adequate healing and functional integration.

Conclusion

The combination of periodontal surgery and advanced restorative techniques successfully addressed the patient's esthetic concerns, achieving a balanced gingival-dental relationship and a natural, harmonious smile. This case demonstrates the value of an interdisciplinary approach in managing complex esthetic challenges, providing predictable and satisfying outcomes for both clinicians and patients.