Fig. 1: Preoperative full-smile view showing excessive gingival display. 

Fig. 2: Measurement of gingival display in smile showing 6.75 mm of visible attached gingiva.

For this patient, CL via a gingivectomy only was necessary to expose the cementoenamel junction (CEJ) as the osseous crest is 2 mm to 3 mm apical to the facial CEJ (Figs. 3 and 4).

Fig. 3: Intraoperative view after gingivectomy/-plasty, teeth Nos. 3 through 8.

Fig. 4: Post-gingivectomy/-plasty view, teeth Nos. 3 through 14.

An elliptical incision removes a partial-thickness segment of vestibular mucosa and contiguous attached gingiva in a 2:1 ratio (Figs. 5 and 6).

Fig. 5: Planned mucogingival incision outlined with marking pen.

Fig. 6: Mucogingival incision after excision of combined full and split-thickness flap.

Fig. 7: Postoperative view (three weeks) after coronal advancement of mucosal flap margin.

Fig. 8: Three weeks postoperative smile view demonstrating pronounced reduction in gingival display (compare with Fig. 1).

When APE coexists with HUL and/or VME, combining this procedure with CL produces optimal results.

GS correction heralds significant esthetic dentistry milestones, allowing restorative dentists, periodontists, orthodontists, and oral surgeons to collaborate optimally in improving gummy smiles and changing people’s lives for the better.