Guided periodontal plastic surgery for the correction of gummy smile using data merging and computer-aided design and computer-aided manufacturing surgical guide.

Abstract

Excessive gingival display, often referred to as a gummy smile, presents a significant esthetic concern and often necessitates precise periodontal intervention. Esthetic crown lengthening is a technique-sensitive procedure, especially when both soft tissue and bone recontouring are required. This case report details the management of a gummy smile in a 25-year-old female patient using a digital workflow that includes data merging, digital smile design, and a computer-aided design and computer-aided manufacturing (CAD-CAM)-fabricated surgical guide. Comprehensive clinical examination, intraoral scanning, standardized photographs, and cone beam computed tomography data were combined to enable accurate diagnosis and virtual treatment planning. A customized CAD-CAM surgical guide was designed to direct gingival and osseous resection during esthetic crown lengthening. Guided periodontal plastic surgery was performed, followed by management of the defect in the maxillary anterior region. Postoperative healing was satisfactory, with a notable reduction in gingival display, stable periodontal parameters, and high patient satisfaction during follow-up visits. This case highlights the clinical benefits of digital workflows for achieving predictable esthetic results in treating gummy smiles.