ESTHETIC CROWN LENGTHENING ASSOCIATED WITH OSTEOTOMY AND OSTEOPLASTY IN THE MANAGEMENT OF EXCESSIVE GINGIVAL DISPLAY ASSOCIATED WITH MAXILLARY EXOSTOSIS: A CASE REPORT

Abstract

Excessive gingival display is a multifactorial esthetic condition that may be associated with alterations in periodontal tissues and underlying osseous structures. This case report aimed to describe the surgical management of a patient with excessive gingival display associated with maxillary exostosis who underwent esthetic crown lengthening combined with osteotomy and osteoplasty. A 20-year-old female patient sought dental care due to dissatisfaction with her smile esthetics. Clinical examination revealed excessive gingival display during smiling, short clinical crowns, and buccal osseous prominences clinically consistent with maxillary exostoses. Following clinical evaluation and surgical planning, gingival plastic surgery was performed in association with elevation of a full-thickness mucoperiosteal flap, followed by osteotomy and osteoplasty for remodeling of the buccal osseous contour. The flap was subsequently repositioned and sutured. Clinical follow-up was performed at 7, 15, and 60 days after the procedure, revealing satisfactory healing, absence of clinical complications, and improvement in the dentogingival contour and smile esthetics throughout the follow-up period. The patient reported satisfaction with the outcome. It was concluded that, in this case, esthetic crown lengthening associated with osteotomy and osteoplasty resulted in a favorable clinical outcome, with improvement in gingival display and dentogingival contour, representing a therapeutic approach applicable to selected cases of excessive gingival display associated with maxillary exostosis.