Schuldt Filho Guenther, Basily Christopher, Danesh Arsalan, Formiga Márcio de Carvalho, Warmling Paulo G
Periodontology, Nova Southeastern University, Clearwater, USA.
Dentistry, Nova Southeastern University, Clearwater, USA.
Cureus. 2025 Apr 14;17(4):e82240. doi: 10.7759/cureus.82240. eCollection 2025 Apr.
Digital workflow has become an important tool for surgical dentistry and helps clinicians plan and treat several conditions. The excessive gingival display, also known as a gummy smile, is one of the conditions where digital planning and 3D-printed surgical guides bring benefits to both patients and surgeons, by increasing the accuracy of the execution, as close as possible, to the proposed planning. The objective of this case report is to show a case of altered passive eruption treated with aesthetic crown lengthening with the use of a 3D-printed surgical guide. After the patient accepted the proposed treatment plan, a surgical guide was printed according to the digital planning. The surgery had an initial gingivectomy guided by the 3D-printed guide, and after raising the mucoperiosteal flap, osteotomy was also guided by a 3D-printed guide. After three months, the patient was sent to the prosthodontist to replace a composite veneer on the left upper central incisor, with the margins exposed after the gingival healing. With 30 months of follow-up, the patient presents great margin stability and periodontal health. The use of digital workflow appears to facilitate the predictability of periodontal aesthetic treatments and may have more applicability shortly.
数字化工作流程已成为口腔外科的一项重要工具，有助于临床医生规划和治疗多种病症。牙龈过度外露，也称为露龈笑，是一种通过数字化规划和3D打印手术导板能让患者和外科医生都受益的病症，它能提高手术执行的准确性，尽可能贴近拟定的规划。本病例报告的目的是展示一例通过使用3D打印手术导板进行美学牙冠延长术治疗被动萌出异常的病例。患者接受拟定治疗方案后，根据数字化规划打印出手术导板。手术首先在3D打印导板的引导下进行牙龈切除术，掀起黏骨膜瓣后，截骨术也由3D打印导板引导。三个月后，患者被转至修复科医生处，在牙龈愈合后暴露边缘的情况下，更换左上中切牙的复合贴面。经过30个月的随访，患者边缘稳定性良好，牙周健康。数字化工作流程的使用似乎有助于提高牙周美学治疗的可预测性，并且在不久的将来可能会有更多应用。
