Dual Digitally Guided Crown Lengthening in Esthetic Area Compromised by Disharmonic Implant Crown

Abstract

INTRODUCTION: A disharmonious smile results from excessive gingival exposure or gingival margin misalignment is a frequent finding in patients. The most common cause is altered passive eruption; however, in the case presented here, the esthetics of the smile is compromised also due to an inadequate implant placement and crown fabrication. CASE PRESENTATION: This case presented a combination of altered passive eruption and a buccally as well as deeply placed implant crown (#10) that led to disproportionate dimensions of an upper lateral incisor. Dual digitally guided crown lengthening surgical procedure for teeth #5 to #12 was performed aiming a better harmony of the smile. Treatment also included placement of tooth veneers and re-made of implant crown. A pleasant smile with appropriate colors and proportions was achieved. All esthetic and periodontal health parameters were maintained throughout the follow-up period (1 year). CONCLUSION: The use of dual digitally guided crown lengthening help to accomplish precision and stability of esthetic outcome, as it guides for both, bone and soft tissue removal. Particularly, in challenging cases with high esthetic demand and complicated factors present, such as the case presented here, the digital approach provides tools to attain excellent treatment outcome.