I hope you had a good spring and are charged up for the summer. I would like to present you with the fourth edition of the Examiner Online. Knowing what your periodontist can offer your practice could greatly help you in making treatment decisions that would give your patients the comfortable, functional and esthetic dentition they always deserve. I hope you find this publication helpful and please do not hesitate to contact me with any question. Your input is greatly appreciated.
Wade A. Diab, DDS, MS
The Gummy Smile, FAQ's
Excessive Gingival Display
The "Gummy Smile" is a common condition defined by the American Board of Periodontology as "Excessive Gingival Display". This condition is often characterized by short clinical crowns and diagnosed as "Altered Passive Eruption". Other conditions that can cause Excessive Gingival Display are a short upper lip (hyperactive lip) and maxillary vertical excess.
What is Altered Passive Eruption? The etiology of this condition is unknown, however; it appears that the sequence of the eruption of the dentition is altered during the passive phase. The passive eruption takes place by physiologic retreat of the alveolar bone and the gingival tissues exposing additional tooth structure and giving the teeth their normal length. The passive eruption occurs between the ages of 11 and 13 and is normally complete by the age of 14.
What is the treatment for Altered Passive Eruption? When this condition is diagnosed, the proper treatment is to perform cosmetic crown lengthening which includes recontouring of the gingival tissues in addition to reflecting a full thickness flap on the facial of the affected teeth and performing osseous recontouring.
What Happens if Osseous Recontourig was not Performed? If the alveolar bone on the facial of the affected teeth was not altered, the gingival tissues will rebound close to their original position before the surgery leading to less than favorable results.
Can Lasers be Used for The Cosmetic Crown Lengthening procedure?
Soft tissue lasers can be used in the soft tissue recontouring phase only. Full reflection of a facial flap has to take place to allow access to the alveolar bone for proper osseous recontouring especially along the line angles of the affected teeth.