Planejamento digital para correção do sorriso gengival: Uma abordagem comparativa com a técnica convencional – Relato de casos

Abstract

Excessive gingival exposure, known as a gummy smile, results in disharmony between the teeth and gums, leading patients to seek periodontal treatment to improve smile aesthetics and self-esteem. One of the therapeutic options for a gummy smile is aesthetic clinical crown lengthening (ACE), a procedure that involves correcting the gingival margin level through gingivoplasty, with or without bone resection. In this context, digital planning has been proposed to enhance the effectiveness and predictability of ACE. The objective of this case report is to compare two approaches for treating a gummy smile: one conventional and the other digital. Two female patients were dissatisfied with their smile aesthetics and, after clinical examination and transgingival probing, were diagnosed with Altered Passive Eruption Type I, Subclass B, for which ACE was indicated. In the conventional approach (Case 1), gingival tissue removal was determined based on the height/width ratio of the anterior teeth, whereas in the digital approach (Case 2), the Digital Smile Design (DSD) software was used to define the amount of tissue to be removed, along with cone beam computed tomography to measure the dentogingival unit. In both cases, bone resection was performed to establish a 3 mm distance between the bone crest and the cementoenamel junction. After 12 months (Case 1) and 4 months (Case 2) postoperatively, both techniques resulted in increased clinical crown length with stable gingival margin positioning, as well as patient satisfaction with the outcome. It is concluded that both the conventional and digital approaches were effective in correcting the gummy smile, contributing to treatment success and the achievement of an aesthetically harmonious smile.