Analysis of Periodontal Tissue Stability After Surgical Correction of Altered Passive Eruption in Individuals With Excessive Gingival Display
This prospective, single-group interventional study will evaluate the stability of periodontal tissues after esthetic periodontal surgery for the correction of altered passive eruption in individuals with excessive gingival display. Ten adult participants with excessive gingival display associated with altered passive eruption and involvement of the alveolar bone will be included. Participants will undergo esthetic crown-lengthening surgery consisting of gingivectomy and osseous recontouring. Periodontal clinical measurements, intraoral digital scans, cone-beam computed tomography, standardized photographs, and patient-reported outcomes will be obtained before surgery and during follow-up. Clinical and three-dimensional tissue changes, esthetic perception, satisfaction, and oral health-related quality of life will be evaluated for up to 12 months after treatment.
Excessive gingival display may be associated with altered passive eruption, a condition characterized by excessive gingival coverage of the anatomical crown and an altered relationship between the gingival margin, cementoenamel junction, and alveolar bone crest. Esthetic crown-lengthening procedures may be indicated to expose the anatomical crown and establish an appropriate periodontal tissue relationship. This prospective, non-randomized, before-and-after clinical study will include 10 adult participants presenting with an esthetic complaint related to excessive gingival display and a diagnosis of altered passive eruption involving the alveolar bone. Before surgery, participants will undergo clinical examination and periodontal preparation. Esthetic periodontal surgery will consist of gingivectomy associated with osseous recontouring. The surgical approach, including flap elevation when required, will be determined according to the periodontal phenotype and local anatomical characteristics. Periodontal clinical measurements will be performed before surgery and during postoperative follow-up. Intraoral digital scanning will be performed before treatment and at 3, 6, and 12 months to evaluate three-dimensional changes and soft-tissue stability. Cone-beam computed tomography will also be used to evaluate periodontal tissue dimensions and remodeling. Standardized intraoral and extraoral photographs will document esthetic changes. Patient-reported outcomes, including postoperative discomfort, esthetic perception, satisfaction, and oral health-related quality of life, will also be assessed. Participants will be followed for 12 months after surgery to determine the stability of the clinical and three-dimensional periodontal outcomes.
Inclusion Criteria: * Adults with an esthetic complaint related to excessive gingival display. * Diagnosis of altered passive eruption as one of the etiologic factors associated with excessive gingival display. * Altered passive eruption involving the alveolar bone.
Exclusion Criteria: * Current orthodontic treatment. * Active periodontal disease. * Systemic conditions that contraindicate periodontal surgical procedures, including uncontrolled autoimmune diseases. * Use of medications that may interfere with the inflammatory response or wound healing, including corticosteroids or immunosuppressive agents. * Current smokers. * Former smokers who discontinued smoking less than 12 months before enrollment. * Pregnant or breastfeeding individuals. * Excessive gingival display primarily associated with lip hypermobility or vertical maxillary excess without concomitant altered passive eruption.
[{"measure":"Mean Change From Baseline in Clinical Crown Length","timeFrame":"Baseline, 2 weeks, 3 months, 6 months, and 12 months after surgery"}]