Dr. Mohammed Nasser
Gummy smile due to altered passive eruption
1-The patient is showing gummy smile measured 4-5 mm which caused her a great disturbance and sadness
(Kokich 1999)
2-abnormal crown width to length ratio 1:1 , while the ideal is 75% – 80 leading to diagnosis of altered passive eruption type 1 as mucogingival junction was far away from CEJ
(Belser UC. Esthetics checklist for the fixed prosthesis. Part II: Biscuit-bake try-in. In: Scha¨rer P, Rinn LA, Kopp FR, editors. Esthetic guidelines for restorative dentistry. Chicago: Quintessence; 1982 )
(Colset , 1977 )
3-gingivectomy
4-full thickness flap was raised showing the alveolar bone is so close to CEJ so this is sub group B or altered active eruption and osseous resection was done then to create favourable biologic width
( Coslet , 1977)
(Zangradno , 2017)
5-flap sutured
6-immediate post operative view
7-pre and post operative immediately
8-post operative 10 days , the patient was totally happy and confident after the resolution of her gummy smile
