ABSTRACT
Introducción: el alargamiento de corona relacionado con la estética tiene como objetivo revelar una longitud adecuada de la corona y disminuir la exposición gingival. El procedimiento incluye gingivectomía y alveolectomía para restablecer el tejido gingival supracrestal requerido protésicamente según la dimensión fisiológica. Mediante un escaneo intraoral del maxilar, mandíbula y posición intercuspídea máxima y utilizando un software especializado, se diseña de manera digital la forma de los dientes y el contorno gingival. Este diseño genera una imagen de la restauración estética deseada para el prostodoncista y periodoncista. La fabricación física del diseño es asistida por computadora (CAD-CAM), creando una guía quirúrgica de resina acrílica moldeada al vacío para determinar la longitud de la corona clínica requerida en la cirugía. Objetivo: el caso interdisciplinario presentado describe una técnica innovadora empleando el flujo digital mediante un software que, a partir de un escaneo oral, diseña de manera digital un Mock-Up utilizado como guía para la cirugía periodontal. Presentación del caso: acude a clínica de la Maestría en Periodoncia de la Universidad Autónoma de Coahuila (UAdeC) paciente de 52 años, ASA I, para una cirugía periodontal con fines estéticos. Se procedió a la cirugía, colocando el Mock-Up en la región anterosuperior como guía para la gingivectomía. Luego, se realizó el levantamiento de colgajo antes de la alveolectomía, tomando en cuenta la longitud del tejido gingival supracrestal. Por último, se suturaron los tejidos blandos con técnica de colchonero horizontal. Resultados: siete días después, se retiran los puntos apreciando una cicatrización correcta y uniforme de los tejidos. Conclusiones: este abordaje digital ofrece una reducción significativa del tiempo quirúrgico, además de una estética satisfactoria y una precisa arquitectura gingival (AU)
Introduction: crown lengthening for aesthetic purposes aims to reveal an adequate crown length and reduce gingival exposure. The procedure includes gingivectomy and alveolectomy to restore the prosthetically required supracrestal gingival tissue according to physiological dimensions. Through an intraoral scan of the maxilla, mandible, and maximum intercuspidal position, and using specialized software, the shape of the teeth and the gingival contour are digitally designed. This design generates an image of the desired aesthetic restoration for the prosthodontist and periodontist. The physical fabrication of the design is computer-assisted (CAD-CAM), creating a vacuum-formed acrylic resin surgical guide to determine the clinical crown length required in surgery. Objective: the presented interdisciplinary case describes an innovative technique using digital workflow through software that, from an oral scan, digitally designs a Mock-Up used as a guide for periodontal surgery. Case presentation: a 52-year-old ASA I patient attended the Periodontics Master's clinic at Universidad Autónoma de Coahuila (UAdeC) for periodontal surgery with aesthetic purposes. The surgery was performed by placing the Mock-Up in the anterosuperior region as a guide for gingivectomy. Then, a flap was raised before the alveolectomy, considering the length of the supracrestal gingival tissue. Finally, the soft tissues were sutured with a horizontal mattress suture technique. Results: seven days later, the sutures were removed, showing correct and uniform tissue healing. Conclusions: this digital approach offers a significant reduction in surgical time, in addition to satisfactory esthetics and precise gingival architecture (AU)
Subject(s)
Humans , Male , Middle Aged , Image Processing, Computer-Assisted/methods , Crown Lengthening , Computer-Aided Design , Imaging, Three-Dimensional/methods , Esthetics, Dental , Schools, Dental , Gingivectomy/methods , MexicoABSTRACT
El reposicionamiento labial es un procedimiento quirúrgico mínimamente invasivo que se utiliza para tratar una sonrisa gingival, la cual, es una afección en la que una cantidad significativa de la encía queda expuesta cuando una persona sonríe y puede deberse a una variedad de factores, como un exceso de tejido gingival, un labio superior corto o músculos hiperactivos del labio superior, entre otros. El alargamiento clínico de la corona, por otro lado, consiste en eliminar el exceso de tejido gingival y, si es necesario, el tejido óseo para exponer una mayor parte de la corona natural del diente. Se reporta un caso clínico de paciente femenino de 31 años que presentó una sonrisa gingival provocada por hipermovilidad de labio superior y un exceso de tejido gingival localizado. El plan de tratamiento involucró una combinación de reposicionamiento labial y alargamiento de corona. Los resultados estéticos fueron significativos, con la sonrisa del paciente más equilibrada y proporcionada. Se redujo la cantidad de tejido gingival expuesto cuando la paciente sonreía y la longitud de los dientes fue más visible, lo que dio como resultado una sonrisa de aspecto más natural, además de aumentar su aceptación al sonreír.
SUMMARY: Lip repositioning is a minimally invasive surgical procedure used to treat a gummy smile, which is a condition in which a significant amount of the gum is exposed when a person smiles and may be due to a variety of factors, such as excess gum tissue, a short upper lip or overactive muscles of the upper lip, among others. Clinical crown lengthening, on the other hand, involves removing excess gingival tissue and, if necessary, bone tissue to expose more of the natural crown of the tooth. Clinical case: A clinical case of a 31-year-old female patient who presented a gummy smile caused by hypermobility of the upper lip and an excess of localized gingival tissue is reported. The treatment plan involved a combination of lip repositioning and crown lengthening. The aesthetic results were significant, with the patient's smile more balanced and displayed. The amount of the patient's exposed gum tissue when smiled was reduced and the length of the teeth was more visible, resulting in a more natural-looking smile, as well as increasing their acceptance of smiling.
Subject(s)
Humans , Female , Adult , Lasers, Solid-State , Gingivectomy , Smiling , Bone and Bones/surgery , Epithelium , Esthetics, Dental , Gingivoplasty , LipABSTRACT
Introduction. Over time, efforts have been invested in the design of new instruments that overcome the disadvantages of the gold standard instrument in surgery, the scalpel. As a result, electronic equipment has emerged such as the electric scalpel and laser devices. The available evidence on these instruments suggests that the tissue response is related to each instrument's physical and biological cutting principles. Objective. To compare the histological changes in gingiva samples associated with surgical cutting performed with a 940 nm diode laser, a 2780 nm erbium, chromium: yttriumscandium-gallium-garnet (Er,Cr:YSGG) laser, and an electric scalpel, by presenting a series of cases. Case presentation. We present three cases of healthy patients undergoing cosmetic surgery. The clinical examination revealed exposure of a keratinized gingiva band greater than 4 mm, normal color and texture in gingival tissue, with a firm consistency and no bleeding on periodontal probing. Gingivectomy was indicated with the following protocols: Diode laser of 940 nm at 1 W, in continuous mode; Er,Cr:YSGG laser of 2780 nm at 2.5 W, 75 Hz, H mode, air 20, water 40, gold tip MT4); and electric scalpel in cutting mode at power level four. Gingival tissue samples were taken and stored in 10% formaldehyde for histological analysis. Conclusion. All the evaluated cutting instruments generated histological changes produced by the thermal effect, the main ones being collagen coagulation and carbonization. The depth of thermal damage caused by the 2780 nm Er,Cr:YSGG laser was much lesser than that induced by the electric scalpel and the 940 nm diode laser.
Introducción. Históricamente se ha invertido esfuerzo en el diseño de nuevos instrumentos que superen las desventajas del estándar de referencia en cirugía, el bisturí. Como consecuencia de esto, han surgido equipos electrónicos como el electrobisturí y los diferentes dispositivos de tecnología láser. La información disponible sobre estos instrumentos sugiere que la respuesta del tejido intervenido está influenciada por los principios físicos y biológicos de corte del instrumento. Objetivo. Comparar los cambios histológicos en muestras de encía asociados al corte quirúrgico realizado con láser de diodo de 940 nm, láser de erbio, cromo: itrio-escandio-galio-granate (Er,Cr:YSGG) (2780nm) y electrobisturí mediante una presentación de serie de casos. Presentación de los casos. Se presentan tres casos de pacientes sanos sometidos a cirugía estética. El examen clínico reveló la exposición de una banda gingival queratinizada mayor de 4 mm, tejido gingival de color y textura normales, de consistencia firme y sin sangrado al sondaje periodontal. Se indicó gingivectomía con los siguientes protocolos: láser de diodo de 940 nm a 1 W, en modo continuo; láser de Er,Cr:YSGG de 2780 nm a 2,5 W, 75 Hz, modo H, aire 20, agua 40, punta de oro MT4; y bisturí eléctrico en modo de corte, a nivel de potencia cuatro. Se tomaron muestras de tejido gingival y se almacenaron en formaldehído al 10 % para su análisis histológico. Conclusión. Los tres instrumentos de corte generaron cambios histológicos producidos por el efecto térmico; los principales fueron coagulación del colágeno y carbonización. La profundización del daño térmico causada por el láser de Er,Cr:YSGG de 2780 nm fue mucho menor que la generada por el electrobisturí y por el láser de diodo de 940 nm.
Subject(s)
Gingivectomy , Artifacts , Lasers, Semiconductor , Lasers, Solid-State , HistologyABSTRACT
Atualmente é evidente a demanda contínua por padrões de beleza, cada vez mais impecáveis, um sorriso alinhado e harmônico com dentes brancos para se sorrir com confiança. O tratamento odontológico interdisciplinar tem como intuito proporcionar uma boa saúde periodontal, restabelecer a estética e a função do sistema estomatognático. Objetivo: apresentar um relato de caso clínico envolvendo harmonização do sorriso como cirurgia plástica periodontal para alinhamento da margem gengival na região anterior e restaurações diretas em resina composta após a finalização do tratamento ortodôntico, evidenciando a importância da abordagem conservadora e multidisciplinar no âmbito do tratamento estético. Relato de caso: Realizamos o tratamento ortodôntico com aparelho autoligado cerâmico para alinhamento do arco dental e intrusão do elemento 13, em sequência executamos um recorte gengival nos elementos 12 e 22, clareamento dental associado após 15 dias, subsequentemente, reanatomização dentária no elemento 44 para que o elemento 13 não voltasse a extruir pela falta de contato oclusal, e por fim, remodelação dental fazendo uso de resina composta nos elementos 12, 21 e 22 devido a manchas de hipocalcificação dental. Conclusão: Contudo, a estética bucal tem a capacidade de possibilitar a melhoria na autoestima, devolvendo à função, proporcionando satisfação e bem-estar ao indivíduo, enaltecendo o sorriso.
Currently, the continuous demand for increasingly impeccable beauty standards is evident, an aligned and harmonic smile with white teeth to smile with confidence. Interdisciplinary dental treatment aims to provide good periodontal health, restore the aesthetics and function of the stomatognathic system. Objective: to present a clinical case report involving smile harmonization as periodontal plastic surgery for aligning the gingival margin in the anterior region and direct composite resin restorations after completion of orthodontic treatment, highlighting the importance of a conservative and multidisciplinary approach in the field of aesthetic treatment . Case report: We performed orthodontic treatment with a self-ligating ceramic appliance for aligning the dental arch and intruding element 13, then performed a gingival cutout on elements 12 and 22, associated tooth whitening after 15 days, subsequently, dental reanatomization on element 44 to that element 13 would not extrude again due to the lack of occlusal contact, and finally, dental remodeling using composite resin in elements 12, 21 and 22 due to dental hypocalcification stains. Conclusion: However, oral aesthetics has the ability to improve self-esteem, returning to function, providing satisfaction and well-being to the individual, enhancing the smile.
Subject(s)
Humans , Female , Adult , Orthodontics, Corrective/methods , Smiling , Esthetics, Dental , Treatment Outcome , Patient Satisfaction , Dental Restoration, Permanent/methods , Orthodontic Appliances, Fixed , GingivectomyABSTRACT
Background: The objective of this systematic review and meta-analysis was to answer the questions ''Does lip repositioning surgery reduce the amount of gingiva exposed in the smile in individuals with excessive gingival display EGD (excessive gingival display)?'' and ''Is the reduction of the amount of gingiva exposed when smiling obtained with lip repositioning surgery stable over time?'' to evaluate the effectiveness of lip repositioning surgery for correcting EGD on smiling. Materials and Methods: A systematic structured search was carried out in five databases without data restriction. Studies reporting the degree of reduction in gingival ex-posure after lip repositioning surgery were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate Results: One hundred sixty-four references were retrieved and eleven studies met the eligibility criteria. Meta-analysis demonstrated that lip repositioning surgery results in a significant reduction in the amount of exposed gingival tissue (mean difference = -3.03; confidence interval = -3.55; -2.52). In addition, the results remained stable in the evaluated follow-up periods (1, 3, 6 and 12 months). Included studies had a low risk of bias. Conclusions: Lip repositioning surgery is effective for the treatment of EGD on smiling and exhibits stable results in the evaluated periods. The study was registered (CRD42020184866) in the international prospective register of systematic reviews (PROSPERO)
Antecedentes: el objetivo de esta revisión sistemática y metanálisis fue responder a las preguntas "¿La cirugía de reposicionamiento de labios reduce la cantidad de encía expuesta en la sonrisa en personas con exposición gingival excesiva (EGE)?" y "¿La reducción de la cantidad de encía expuesto al sonreír obtenido con cirugía de reposicionamiento de labios estable en el tiempo?" para evaluar la efectividad de la cirugía de reposicionamiento de labios para corregir la EGE al sonreír. Materiales y Métodos: Se realizó una búsqueda sistemática estructurada en cinco bases de datos sin restricción de datos. Se incluyeron los estudios que informaron el grado de reducción de la exposición gingival después de la cirugía de reposición de labios. La selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo se realizaron por duplicado. Resultados: Se recuperaron ciento sesenta y cuatro referencias y once estudios cumplieron con los criterios de elegibilidad. El metanálisis demostró que la cirugía de reposicionamiento de labios da como resultado una reducción significativa en la cantidad de tejido gingival expuesto (diferencia de medias = -3,03; intervalo de confianza = -3,55; -2,52). Además, los resultados se mantuvieron estables en los periodos de seguimiento evaluados (1, 3, 6 y 12 meses). Los estudios incluidos tenían un bajo riesgo de sesgo. Conclusión: La cirugía de reposicionamiento de labios es efectiva para el tratamiento de la EGE al sonreír y presenta resultados estables en los períodos evaluados. El estudio fue registrado (CRD42020184866) en el registro prospectivo internacional de revisiones sistemáticas (PROSPERO).
Subject(s)
Humans , Gingiva/surgery , Gingivectomy , Lip/surgery , Smiling , Esthetics, DentalABSTRACT
Introduction : La prise en charge de l'accroissement gingival repose sur un entretien médical bien mené, un examen clinique rigoureux, un diagnostic bien posé et une exérèse chirurgicale. Cependant, une récidive de la lésion peut être observée avec un rendu gingival souvent inesthétique. L'objectif de ce travail était d'illustrer, à travers un cas clinique, l'apport de la gingivectomie et de la frénectomie dans la prise en charge d'un accroissement gingival associé à un frein pathologique. Observation : Il s'agissait d'un patient âgé de 27 ans, venu consulter pour un problème esthétique lié à une excroissance gingivale. L'examen exo-buccal a mis en évidence, une asymétrie faciale dans le sens horizontal. La lésion gingivale était visible au sourire et évoluant depuis plus de 5 ans. L'examen endo-buccal a relevé la présence d'une gingivite induite par le biofilm, d'un frein de type 4 de Placek associés à un accroissement gingival pédonculé saignant au contact et siégeant entre la 11 et la 21. Après la thérapeutique initiale et une réévaluation, une gingivectomie à biseau interne (GBI) associée à une frénectomie ont été réalisées. L'examen anatomo-pathologique a mis en évidence un épulis fibreux ou fibrome périphérique avec absence de signes histologiques de malignité. L'évolution après 6 mois est marquée par une muqueuse gingivale cliniquement saine avec absence de récidive. Conclusion : L'apport de la gingivectomie et de la frénectomie est un atout important en termes de résultat clinique et de limitation de récidives dans l'exérèse des excès gingivaux combinés à un frein labial pathologique.
Introduction: Gingival growth is a change in the size and/or multiplication of cells, the gingival vascular system and the extracellular matrix. Management is based on a wellconducted medical interview, a rigorous clinical examination, a well-made diagnosis and surgical excision. However, a recurrence of the lesion can be observed with an often unsightly gingival rendering. The objective of this work was to illustrate, through a clinical case, the contribution of gingivectomy and frenectomy in the management of gingival growth associated with a pathological frenulum. Observation: It was a patient aged 27 who came to consult for an aesthetic problem related to a gingival growth. The exo-oral examination highlighted, a facial asymmetry in the horizontal direction. The gum lesion was visible on the smile and had been evolving for more than 5 years. The endooral examination noted the presence of biofilm-induced gingivitis, a type 4 Placek frenulum associated with pedunculate gingival growth bleeding on contact and sitting between 11 and 21. After initial therapy and reassessment, an internal bevel gingivectomy (IGG) combined with frenectomy was performed. The anatomo-pathological examination revealed fibrous epulis or peripheral fibroid with absence of histological signs of malignancy. The evolution after 6 months is marked by a clinically healthy gingival mucosa with no recurrence. Conclusion: The contribution of gingivectomy and frenectomy is an important asset in terms of clinical outcome and limitation of recurrence in the excision of excess gingival combined with a pathological labial frenulum.
Subject(s)
Humans , Male , Gingival Overgrowth , GingivectomyABSTRACT
el tratamiento ortodóntico es responsable del agrandamiento gingival (ag), una condición clínica caracterizada por el crecimiento patológico, difuso o localizado del tejido gingival. La acumulación excesiva de la matriz extracelular (mec), incluyendo el colágeno tipo I, parece contribuir a las manifestaciones patológicas del ag. El objetivo del artículo es identificar y describir la distribución del colágeno tipo I en el tejido gingival de pacientes con ag por ortodoncia fija. Materiales y métodos: estudio de tipo descriptivo que analizó los tejidos gingivales de sujetos diagnosticados con ag portadores de ortodoncia (test, n = 5) e individuos periodontalmente sanos (control, n = 5). Las muestras se obtuvieron mediante gingivectomía. Todas las biopsias fueron fijadas, incluidas en parafina, cortadas y analizadas por medio de la coloración rojo picrosirius/verde rápido, con el propósito de distinguir las fibras de colágeno. Mediante una reacción inmunohistoquímica, el colágeno tipo I fue identificado con anticuerpo monoclonal. Resultados: en los pacientes con ag por tratamiento ortodóntico, se identificó un tejido epitelial hiperplásico con aumento evidente de las prolongaciones epiteliales y un tejido conectivo con abundantes haces de fibras de colágenos, principalmente en la lámina basal y la zona subyacente. Las fibras de colágeno tipo I en los tejidos de pacientes con ag por ortodoncia fueron gruesas de aspecto desorganizado, con una tinción inmunohistoquímica intensa, en comparación con las fibras del grupo control. Conclusiones: el aumento de fibras de colágenos, en especial de colágeno de tipo I, es un hallazgo histológico que caracteriza a los pacientes con ag por ortodoncia fija.
Orthodontic treatment is responsible for gingival overgrowth (go), a clinical condition charac-terized by pathological, diffuse, or localized growth of gingival tissue. Excessive accumulation of the extra-cellular matrix, including type I collagen, contributes to the pathological manifestations of go. The objective of this study is to identify and describe the distribution of type I collagen in the gingival tissue of patients with go because of fixed orthodontics. Materials and Methods: A descriptive study that analyzed the gingival tissues of subjects diagnosed with go with orthodontic (test, n = 5) and periodontally healthy individuals (control, n = 5). The samples were obtained by gingivectomy. All the biopsies were fixed, embedded in paraf-fin, and cut and analyzed using picrosirius red/fast green staining, in order to distinguish the collagen fiber. By means of an immunohistochemical reaction, type I collagen was identified with a monoclonal antibody. Results: A hyperplastic epithelial tissue was identified with an evident increase in epithelial processes and connective tissue with abundant bundles of collagen fiber, mainly in the basal lamina and the underlying area in patients with go because of orthodontic treatment. Type I collagen fiber in the tissues of patients with orthodontic go were thick and disorganized in appearance with intense immunohistochemical stain-ing, compared to the fibers of the control group. Conclusions:The increase in collagen fibers, particularly type I collagen, is a histological finding that characterizes patients with go because of fixed orthodontics.
⢠tratamento ortodôntico é responsável pelo aumento gengival (ag), uma condição clínica caracterizada pelo crescimento patológico difuso ou localizado do tecido gengival. O acúmulo excessivo de matriz extracelular (mec), incluindo colágeno tipo I, parece contribuir para as manifestações patoló-gicas do ag. O objetivo deste trabalho é identificar e descrever a distribuição do colágeno do tipo I no tecido gengival de pacientes com AG devido à ortodontia fixa. Materiais e métodos: estudo descritivo que analisou os tecidos gengivais de indivíduos diagnosticados com ag em uso de ortodontia (teste, n = 5) e indivíduos periodontalmente saudáveis (controle, n = 5). As amostras foram obtidas por gengivectomia. Todas as biópsias foram fixadas, embebidas em parafina, cortadas e analisadas com coloração picrosirius vermelho/verde rápido, a fim de distinguir as fibras colágenas. Usando uma reação imuno-histoquímica, o colágeno tipo I foi identificado com anticorpo monoclonal. Resultados: em pacientes com ag devido ao tratamento ortodôntico, foi identificado tecido epitelial hiperplásico com evidente aumento das exten-sões epiteliais e tecido conjuntivo com abundantes feixes de fibras colágenas, principalmente na lâmina basal e região subjacente. As fibras de colágeno tipo I em tecidos de pacientes com ag ortodôntico eram espessas com aspecto desorganizado e intensa coloração imuno-histoquímica, em comparação com as fibras do grupo controle. Conclusões: o aumento das fibras colágenas, principalmente do colágeno do tipo I, é um achado histológico que caracteriza os pacientes com ag devido à ortodontia fixa.
Subject(s)
Humans , Orthodontics , Patients , Biopsy , Gingival Overgrowth , Collagen Type I , GingivectomyABSTRACT
Introducción: La hiperplasia gingival es una condición benigna caracterizada por el aumento de volumen de la encía. Algunos fármacos, factores genéticos, aparatología y placa dentobacteriana son factores que pueden inducir esta condición. Objetivo: Devolver la anatomía a la encía brindando una mejor estética y permitiendo una óptima higiene oral. Material y métodos: Paciente masculino de 20 años de edad con antecedentes de fenitoína presenta aumento de volumen en la encía. Resultados: Se obtuvieron resultados estéticos y funcionales satisfactorios con el tratamiento quirúrgico y el uso de membrana de celulosa oxidada. Conclusión: En el manejo de la hiperplasia gingival es importante el enfoque no quirúrgico como control de placa dentobacteriana y medidas de higiene del mismo paciente (AU)
Introduction: Gingival hyperplasia is a benign condition characterized for the grown on the gingival volume. Some drugs, genetic, orthodontic and dental plaque are some factors that can induce this condition. Objective: To return the gingival anatomy, providing a better aesthetic allowing also good oral hygiene. Material and methods: A male 20 years of age with medical history of phenytoin display grown on the gingival volume. Results: Aesthetic and functional results were achieved with the surgical treatment and the oxidized cellulose membrane. Conclusion: In the gingival hyperplasia management is important de non-surgical approach, as dental plaque control and oral hygiene of the patient (AU)
Subject(s)
Humans , Female , Adult , Phenytoin/adverse effects , Cellulose, Oxidized , Gingival Hypertrophy/chemically induced , Gingivectomy , Esthetics, Dental , Membranes, Artificial , MexicoABSTRACT
Os lasers de diodo tornaram-se ferramentas clínicas populares devido ao seu tamanho compacto, acessibilidade, facilidade de uso e versatilidade. O objetivo deste artigo é apresentar as diversas aplicações de um laser de diodo na prática diária e destacar os aspectos técnicos do uso do laser de diodo para o mesmo. Esta série de casos relata o manejo de seis diferentes situações clínicas com laser de diodo: anquiloglossia, bolsa periodontal, zênites gengivais desiguais, mucocele, hipersensibilidade dentinária e gengiva hiperpigmentada. Os pacientes foram tratados com laser de diodo de 940 nm com potência de 0,5 W a 2 W dependendo do caso. A cicatrização pós-operatória transcorreu sem intercorrências na maioria dos casos e foram observados resultados favoráveis. O laser de diodo ofereceu vantagens cirúrgicas como campo seco, desinfecção do sítio cirúrgico e cirurgia sem sutura. Além disso, os autores observaram melhor satisfação do paciente devido à mínima dor ou edema pós-operatório e alívio imediato em caso de hipersensibilidade dentinária. Este artigo apresenta as aplicações cirúrgicas e não cirúrgicas do laser de diodo juntamente com os aspectos técnicos. Embora a literatura disponível não forneça evidências substanciais para comparação direta do laser de diodo com as técnicas convencionais, é seguro concluir que o laser de diodo é uma ferramenta eficiente para uso rotineiro em odontologia.(AU)
The diode lasers have become popular clinical tools because of their compact size, affordability, ease of use and versatility. The aim of this paper is to put forth the various applications of a diode laser in day to day practice and highlight the technical aspects of diode laser use for the same. This case series reports management of six different clinical situations with diode laser namely ankyloglossia, periodontal pocket, unequal gingival zeniths, mucocele, dentinal hypersensitivity and hyper-pigmented gingiva. The patients were treated with 940 nm diode laser with power settings from 0.5 W to 2 W depending on the case. The post-operative healing was uneventful in most cases and favourable outcomes were observed. The diode laser offered surgical advantages like dry field, disinfection of surgical site and suture-less surgery. In addition, the authors observed better patient satisfaction owing to minimal post-operative pain or swelling and immediate relief in case of dentinal hypersensitivity. This paper presents both surgical and non-surgical applications of diode laser along with the technical aspects. Even though the available literature does not lend substantial evidence for direct comparison of diode laser with conventional techniques, it is safe to conclude that diode laser is an efficient tool for routine use in dentistry.(AU)
Subject(s)
Humans , Adult , Periodontal Pocket , Dentin Sensitivity , Esthetics, Dental , Laser Therapy , Ankyloglossia , GingivectomyABSTRACT
Introducción: Las técnicas de coloración histológica son útiles en el análisis ultraestructural de muestras tisulares, incluyendo el tejido gingival. Objetivo: Comparar la utilidad de tres métodos histoquímicos (hematoxilina-eosina, Masson Goldner y rojo sirio) en la identificación de elementos celulares y otros constituyentes del tejido gingival. Métodos: Estudio experimental in vitro que comprendió el análisis de tejidos gingivales de donantes sanos sin signos de inflamación gingival y con indicación de cirugía periodontal. Las muestras de encía se obtuvieron mediante gingivectomía, se procesaron e incluyeron en parafina, posteriormente se realizaron cortes con un micrótomo y se depositaron en portaobjetos de adhesión con polisina. Las muestras se agruparon y fueron teñidas con hematoxilina-eosina, Masson Goldner y rojo sirio, finalmente fueron visualizadas en un microscopio óptico Leica DM 750®. La lectura de los hallazgos fue realizada por patólogos orales. Resultados: La coloración hematoxilina-eosina evidencia elementos celulares y extracelulares del tejido epitelial y conectivo. Núcleos de color azul violeta, citoplasmas rosados, fibras de colágeno de matiz rosa claro, arteriolas y vénulas con túnica adventicia, media e íntima diferenciadas. La coloración Masson Goldner diferencia núcleos de coloración púrpura y citoplasma fucsia, presenta especificidad en identificar fibras de colágeno con tonalidad verde, distribuidas densa, homogénea y paralelamente en el tejido conectivo gingival. La tinción rojo sirio, permitió identificar las fibras de colágeno de color rosa brillante, mientras que el tejido epitelial y los vasos sanguíneos fueron de color amarillo. Conclusión: Cada coloración histológica evaluada en el presente trabajo tiene cierta afinidad y sensibilidad por estructuras celulares y componentes de la matriz extracelular específica. Su empleo es útil en el estudio de tejidos gingivales y podrían contribuir en el análisis de biopsias gingivales(AU)
Introduction: Histological staining techniques are useful in the ultrastructural analysis of tissue samples, including gingival tissue. Objective: Compare the usefulness of three histochemical methods (hematoxylin-eosin, Masson-Goldner and sirius red) for identification of cellular elements and other constituents of gingival tissue. Methods: An in vitro experimental study was conducted which included the analysis of gingival tissue from healthy donors without gingival inflammation signs and indication of periodontal surgery. The gum samples were obtained by gingivectomy, processed with paraffin, cut with a microtome and placed on Polysine adhesion slides. The samples were grouped, stained with hematoxylin-eosin, Masson Goldner and sirius red, and visualized under a Leica DM 750® microscope. Reading of the findings was performed by oral pathologists. Results: Hematoxylin-eosin staining found cellular and extracellular elements of the epithelial and connective tissue: violet-blue nuclei, pink cytoplasms, light rose collagen fibers, and arterioles and venules with differentiated tunica adventitia, media and intima. Masson-Goldner staining differentiated purple nuclei and fuchsia cytoplasm. It displayed specificity identifying green collagen fibers with dense, homogeneous and parallel distribution in the gingival connective tissue. Sirius red staining allowed identification of bright rose collagen fibers, whereas epithelial tissue and blood vessels were yellow. Conclusion: Each of the histological staining methods evaluated in the study shows a certain affinity with and sensitivity to cellular structures and components of the specific extracellular matrix. All three are useful for the study of gingival tissue and could contribute to the analysis of gingival biopsies(AU)
Subject(s)
Humans , Connective Tissue/injuries , Gingivectomy , Hematoxylin , In Vitro Techniques , CollagenABSTRACT
Este relato descreve o caso de uma paciente jovem que necessitou de reabilitação na região maxilar anterior devido a insatisfações estéticas. O artigo objetivou relatar a sequência clínica da reabilitação de um implante pré-existente na região do dente 21 com UCLA de zircônia personalizável e coroa de dissilicato de lítio associada a instalação de facetas de dissilicato de lítio dos dentes 15 ao 25 para harmonização do sorriso. Previamente ao tratamento reabilitador, foi realizado o planejamento do caso que incluiu a necessidade de gengivectomia e condicionamento do perfil de emergência na região peri-implantar. Após a cicatrização, foram confeccionados preparo minimamente invasivos de acordo com as informações do mock-up. UCLA personalizável de zircônia foi selecionada como componente protético, visando a estética do caso. Para a moldagem, utilizou-se transfer de moldeira aberta para cópia do perfil de emergência e posicionamento do implante na região do 21 e moldagem simultânea com silicone de adição. Após a prova, a cimentação das facetas de dissilicato de lítio foi realizada com cimento adesivo fotopolimerizável. Os resultados estéticos e funcionais foram satisfatórios. No presente caso clínico, conclui-se a importância da abordagem multidisciplinar para alcançar resultados satisfatórios. Ademais, a associação das facetas e a coroa de dissilicato de lítio implantossuportada com UCLA de zircônia personalizável proporcionou os resultados estéticos e funcionais da paciente(AU)
This report describes the case of a Young patient who needed rehabilitation in the anterior maxillary region due to esthetic involvement. The article aimed to report the clinical sequence of the rehabilitation of a pre-existing implant in the region of tooth 21 with UCLA of zirconia customizable and crown of lithium disilicate associated with the installation of veneers of lithium disilicate of teeth 15 to 25 for harmonizing the smile. Prior to the rehabilitation treatment, case planning was carried out, which included the need for gingivectomy and conditioning of the emergency profile in the peri-implant region. After healing, preparations minimally invasive were made according to the information of mock-up. UCLA of zirconia customizable was selected as a prosthetic component, aiming at the aesthetics of the case. For impression, open tray transfer was used to copy the emergency profile and position the implant in the region of 21 and simultaneous impression with addition silicone. After the test of veneers, the cementation of veneers of lithium disilicate was performed with adhesive cement light-curing. The esthetic and functional results were satisfactory. In the present clinical case, the importance of a multidisciplinary approach to achieve satisfactory results is concluded. In addition, the combination of veneers and crow implanted of lithium disilicate with customizable zirconia UCLA provided the patient's esthetic and functional results(AU)
Subject(s)
Humans , Female , Adult , Dental Implants , Dental Veneers , Esthetics, Dental , Ceramics , Dental Prosthesis Design , GingivectomyABSTRACT
@#An attractive smile enhances the appearance and acceptance of an individual in society. Gum exposure more than 3 mm is generally considered unattractive and known as a gummy smile, which is usually considered an aesthetic problem. At present, patients have a greater desire for more aesthetic results that may influence the planning of dental treatments. This case report aimed to describe the surgical sequence of aesthetic crown lengthening to improve smile profile and eliminate gummy smile. We reported a 21-year-old non-smoking woman with no pertinent medical history who presented with a chief complaint of an unattractive smile due to excessive gingival display. The gingival display in the smile was 5 mm, and the width to height ratio of the central incisor was 121%. Neither periodontal problems nor teeth mobility was detected. Assessment for the condition was excessive gingival display due to altered passive eruption. The overall prognosis for this case was good. The primary treatment plan proposed to the patient was an aesthetic crown lengthening. Altered passive eruption class I subtype A was a case conclusion, and aesthetic crown lengthening with gingivectomy without osseous reduction was the selected treatment. In conclusion, aesthetic crown lengthening should be considered as a surgical component of aesthetic therapy to improve smile profile and eliminate gummy smile.
Subject(s)
Crown Lengthening , GingivectomyABSTRACT
Resumen Los agrandamientos gingivales inducidos por placa bacteriana asociados a factores locales como el uso de aparatología ortodóntica, son frecuentemente observados en pacientes jóvenes, con un inadecuado control del biofilm dental. Dentro de la terapéutica recomendada para tratar dicha condición se encuentra la fase higiénica periodontal y el abordaje quirúrgico. Se presenta un caso clínico de un paciente de 16 años con agrandamiento gingival y su respectivo tratamiento.
Absytract Dental plaque-induced gingival enlargements associated with local factors such as the use of orthodontic appliances are frequently observed in young patients, with inadequate dental biofilm control. Among the recommended therapeutics to treat this condition is the Nonsurgical phase and the surgical approach. A clinical case of a 16-year-old patient with a gingival enlargement and its respective treatment is presented.
Subject(s)
Humans , Male , Adolescent , Gingivectomy/methods , Gingivitis/diagnosisABSTRACT
A exposição excessiva de gengiva durante o sorriso é denominada como sorriso gengival. O fator etiológico dessa alteração é variado e sua identificação é fundamental para confecção de um plano de tratamento eficaz. O planejamento clínico pode ser realizado utilizando uma abordagem dinâmica e digital do sorriso. Sendo assim, software, exames imaginológicos, modelo virtual 3D e guia cirúrgico aumentam a qualidade e a precisão do tratamento, trazendo inúmeros benefícios para o paciente. Objetivo: demonstrar a importância do fluxo digital no planejamento e na correção do sorriso gengival. Relato de caso: paciente apresentou queixas em relação ao tamanho dos dentes e ao excesso de exposição de gengiva durante o sorriso. Após exames clínico e radiográfico, foi possível realizar o diagnóstico do fator etiológico como erupção passiva alterada (EPA). O tratamento de escolha foi o recontorno gengival associado à realização de osteotomia e osteoplastia. Para uma maior precisão do tratamento, foi confeccionado um guia cirúrgico duplo. Após o procedimento, a paciente foi orientada e medicada. Considerações finais: a abordagem digital do sorriso favoreceu um tratamento cirúrgico preciso, eficaz e satisfatório para a paciente, reestabelecendo assim a harmonia dento-gengivo-facial.(AU)
Excessive gum exposure during a smile is called a gum smile. The etiologic factor of this alteration is varied, the identification is essential to create an effective treatment plan. Clinical planning can be performed using a dynamic and digital smile approach. Therefore, software, imaging tests, 3D virtual model and the surgical guide increase the quality and precision of the treatment thus bringing numerous benefits to the patient. Objective: this case report aims to demonstrate the importance of digital flow in smile planning and correction of a gum smile. Case report: the patient presented complaints regarding tooth size and excessive gum exposure during the smile. After the clinical and radiographic examination, the etiological factor was diagnosed as an altered passive eruption (APE). The treatment of choice was the gingival contour associated with osteotomy and osteoplasty. For the precision of the treatment, a double surgical guide was made. After the procedure the patient was guided and medicated. Conclusion: the digital smile approach favored an accurate, effective and satisfactory surgical treatment for the patient thus restoring the tooth-gingival-facial harmony.(AU)
Subject(s)
Humans , Female , Adult , Smiling , Tooth Crown/surgery , Gingiva/surgery , Osteotomy/methods , Tooth Eruption , Tomography, X-Ray Computed , Treatment Outcome , Gingivectomy/methodsABSTRACT
Se entiende por agrandamiento gingival el incremento en masa y volumen del tejido gingival. Se considera una condición benigna de la cavidad oral, por lo general de manejo rutinario, que logra regularse con medidas simples de control del biofilm microbiano. El agrandamiento gingival puede ser producido por diversas condiciones clínicas, hereditarias, deficiente higiene oral o fármacos. La epilepsia afecta a 1% de la población mundial y requiere el uso de fármacos antiepilépticos o anticonvulsivantes para lograr su control, dentro de éstos la fenitoína actúa como un bloqueador selectivo de los canales de sodio sensibles al voltaje y constituye uno de los fármacos más empleados por su capacidad en el control de crisis focales y generalizadas. La fenitoína se ha relacionado con los agrandamientos gingivales como uno de sus efectos adversos, los cuales se incluyen dentro de las enfermedades por fármaco inducidas en la cavidad oral. El objetivo de este artículo es brindar la información necesaria sobre el manejo correcto de pacientes con agrandamiento gingival producido por fenitoínas y a la vez poder conocer las consecuencias de estos fármacos en la cavidad oral (AU)
Gingival enlargement means the increase in mass and volumen of the gingival tissue. It is considered a benign condition of the oral cavity, usually of routine management, wich can be regulated with simple measures of biofilm control. The gingival enlargement can be produced by diverse clinical conditions, hereditary deficient oral higiene or drugs. Epilepsy affects 1% of the world population and requires the use of antiepileptic or anticonvulsant drugs to achieve its control, within these phenytoin acts as selective blocker or voltage sensitive sodium channels and is one of the most used grugs for its ability to control focal and generalized crises. Phenytoin has been linked to gingival enlargement as one of its adverse effects which is included within the drug diseases induced in the oral cavity. The objective of this article is to provide the necessary information on the correct managment of patients with gingival enlargemen produced by phenytoins and at the same time to know the consequences of these drugs in the oral cavity (AU)
Subject(s)
Humans , Female , Adult , Phenytoin/adverse effects , Gingival Overgrowth/chemically induced , Gingival Hyperplasia/chemically induced , Schools, Dental , Electrosurgery/methods , Gingival Hyperplasia/surgery , Gingivectomy/methods , Membranes, Artificial , Mexico , Anti-Bacterial Agents/therapeutic useABSTRACT
RESUMEN Introducción: Al realizar una intervención quirúrgica, el instrumento de corte utilizado cobra especial importancia, pues el mismo está vinculado a los signos y síntomas intra- y posoperatorios y al tiempo de reparación de los tejidos. En respuesta a esto, con el tiempo se han propuesto nuevos instrumentos, particularmente la tecnología láser ha venido sufriendo un avance rápido y significativo y en la actualidad se utiliza para un sinnúmero de tratamientos odontológicos. Al láser se le han atribuido diferentes ventajas en la cirugía estética periodontal: desde facilitar el proceso de hemostasia, hasta la estimulación del proceso de reparación tisular. Sin embargo, es pertinente realizar estudios que demuestren a nivel histológico los cambios que generan en la mucosa oral y obtener información que permita conocer de qué manera influye en el proceso de reparación del tejido. Objetivo: Describir los hallazgos histológicos asociados al corte con láser de Er, Cr: YSGG de 2780 nm en muestras de encía obtenidas mediante gingivectomía. Presentación del caso: Paciente femenina, de 21 años, sistémicamente sana. Asistió a la consulta por presentar por inconformidad estética al sonreír. Se diagnosticó con exposición de banda de encía queratinizada mayor que 4 mm. Como parte del plan de tratamiento se indicó gingivectomía con láser de Er, Cr: YSGG (2780 nm) (Waterlase®, BIOLASE®), el procedimiento se realizó solo bajo anestesia tópica. Se tomaron muestras histológicas de tejido gingival para análisis histológico. Conclusiones: El láser Er, Cr: YSGG (2780 nm) preservó la morfología de los fibroblastos después del corte, no hubo evidencia de carbonización, ni profundización de la lesión térmica en el tejido. Este instrumento fue una herramienta de gran utilidad para la ejecución del tratamiento en este caso. Tuvo ventajas importantes como la ausencia de dolor posoperatorio, buena hemostasia y la reparación epitelial casi completa en tan solo 4 días(AU)
ABSTRACT Introduction: When performing a surgical intervention, the cutting instrument used is especially important, since it is associated with intraoperative and postoperative signs and symptoms and to the time of tissue repair. In response to this, new instruments have been proposed over time, particularly laser technology has been undergoing rapid and significant advancement and is currently used for countless dental treatments. Laser has been attributed different advantages in periodontal cosmetic surgery: from facilitating the hemostasis process, to stimulating the tissue repair process. However, it is pertinent to carry out studies that prove, at histological level, the changes in the oral mucosa and obtain information that allows us to know how it influences the tissue repair process. Objective: To describe the histological findings associated with the Er, Cr: YSGG (2780 nm) laser cut in gum samples obtained by gingivectomy. Case presentation: Female patient, 21 years old, systemically healthy. She attended the consultation for presenting aesthetic dissatisfaction when smiling. She was diagnosed with exposure of keratinized gum band greater than 4 mm. As part of the treatment plan, Er, Cr: YSGG (Waterlase®, BIOLASE®, 2780 nm) laser gingivectomy was indicated. The procedure was performed only under topical anesthesia. Histological samples of gingival tissue were taken for histological analysis. Conclusions: The Er, Cr: YSGG (2780 nm) laser preserved the morphology of the fibroblasts after the cut. There was no evidence of carbonization or deepening of the thermal injury in the tissue. In this case, this instrument was a very useful tool for the performance of the treatment. It had important advantages, such as the absence of postoperative pain, good hemostasis, and almost complete epithelial repair in just four days(AU)
Subject(s)
Humans , Female , Young Adult , Gingivectomy/adverse effects , Esthetics, Dental , Lasers, Solid-State/therapeutic useABSTRACT
El aumento en la demanda de tratamientos de odontología estética ha conducido al desarrollo de una comunicación multidisciplinaria entre las diferentes especialidades para lograr el éxito. La sonrisa gingival es un problema estético frecuente que consiste en una exposición excesiva de la encía durante la sonrisa y cuyas modalidades de tratamiento van desde una gingivectomía hasta el levantamiento de un colgajo para la remoción de hueso excedente. Las restauraciones con carillas directas de resinas compuestas son adecuadas para la conservación y la mejora estética del sector anterior, con óptima estética y durabilidad, además de ser consideradas un tratamiento mínimamente invasivo debido a sus conceptos conservadores de preservar la estructura dentaria.El presente caso clínico describe el tratamiento de un paciente joven con sonrisa gingival y alteración en forma y color de los dientes anteriores, mediante procedimientos mínimamente invasivos tales como la gingivectomía y la rehabilitación con carillas directas de resinas compuestas, con el objetivo máximo de preservar la estructura dentaria y una mayor predictibilidad estético-funcional. (AU)
The increasing demand of patients for esthetics dentistry treatments has led to the development of multidisciplinary communication between approaches among different specialties to achieve treatment success. The gummy smile is a frequent esthetic problem, which consists of excessive exposure of the gum when smiling. Treatment modalities range from gingivectomy to flap lift for the removal of excess bone. Restoration with direct veneers of composite resins is suitable for the preservation and esthetic improvement of the anterior sector, with optimal aesthetics and durability. In addition, minimally invasive treatment can be considered due to its conservative concepts of preserving the dental structure.The present case describes the treatment of a young patient with gummy smile and alteration in shape and color of the anterior teeth, through minimally invasive procedures such as gingivectomy and rehabilitation with direct veneers of composite resins with the objective of preserving the dental structure and greater esthetic - functional predictability. The present case report describes the treatment of a young patient with gummy smile. The shape and color of the anterior teeth were altered by minimally invasive procedures including gingivectomy and rehabilitation with direct veneers of composite resins with the objective of preserving the dental structure and providing greater esthetic - functional predictability. (AU)
Subject(s)
Humans , Female , Adolescent , Smiling , Composite Resins , Dental Veneers , Esthetics, Dental , Gingivectomy , Mouth RehabilitationABSTRACT
Hereditary gingival fibromatosis (HGF) is a rare genetic condition characterized by slow and progressive gingival enlargement. The gingival overgrowth often delays teeth eruption and may cause serious functional and aesthetic problems. We reported a case of a 10-year-old female child presenting a generalized gingival enlargement covering almost all the maxillary and mandibular teeth and resulted in problems for swallowing, speaking, and poor aesthetics. An incisional biopsy was performed and revealed a hypocellular and hypovascular dense collagenous tissue covered by squamous epithelium exhibiting acanthosis and elongated rete ridges. The diagnosis was HGF. The treatment instituted was an association of gingivectomy with a rigorous program of oral hygiene and follow-up. Herein, we describe a rare non-syndromic case of generalized HGF, including clinical and microscopical features, as well as highlighting the importance of correct diagnosis of this genetic condition.
Subject(s)
Humans , Female , Child , Fibromatosis, Gingival/pathology , Dentition, Permanent , GingivectomyABSTRACT
Objectives: To evaluate the type of "periodontal treatment" performed by general dental practitioners and the referral patterns of periodontists in Iraq. Material and methods: A total of 201 general dentists were asked to complete a self-administered questionnaire consisting of nine questions regarding periodontal treatment and the referral patterns of periodontists. Results: The study showed that 91.1% of general dental practitioners (GDPs) performed "phase-I therapy", and most of them done "scaling". Regarding surgical periodontal therapy, only 12.9% of them performed surgical periodontal therapy, half of the GDPs did gingivectomy, and less than 30% performed crown lengthening. When evaluating maintenance therapy after periodontal treatment, it was found that 77.9% of the GDPs scheduled appointments for patients in the maintenance phase, 49.4% of them after one month, 24.7% after three months, and 15.6% after six months. Using TRUF analysis, most general dentists believed that the patient and periodontal factors were responsible for the recurrence of periodontal disease. Conclusions: There is still a lack of awareness of periodontal surgical procedures among the "general dental practitioners". Thus, it is essential to increase the comprehension of periodontal treatment among general dentists. (AU)
Objetivo: Avaliar o tipo de "tratamento periodontal" realizado por dentistas generalistas e os padrões de encaminhamento aos periodontistas, no Iraque. Material e métodos: Um total de 201 dentistas generalistas preencheram um questionário autoaplicável que consistiu em nove perguntas sobre o tratamento periodontal e os padrões de encaminhamento para periodontistas. Resultados: O estudo mostrou que 91,1% dos dentistas gerais (DG) realizavam "terapia fase I" e a maioria realizava "raspagem". Em relação à terapia periodontal cirúrgica, apenas 12,9% deles realizavam, sendo que metade dos DG realizavam gengivectomia e menos de 30% realizavam aumento de coroa clínica. Ao avaliar a terapia de manutenção após o tratamento periodontal, constatou-se que 77,9% dos DGs agendaram consultas para pacientes em fase de manutenção, sendo 49,4% após um mês, 24,7% após três meses e 15,6% após seis meses. Usando a análise TRUF, a maioria dos dentistas gerais acredita que o paciente e os fatores periodontais são responsáveis pela recorrência da doença periodontal. Conclusões: Ainda existe um desconhecimento dos procedimentos cirúrgicos periodontais entre os "dentistas generalistas". Assim, é essencial aumentar a compreensão do tratamento periodontal entre os cirurgiões-dentistas gerais (AU)
Subject(s)
Humans , Periodontics , Dental Scaling , Dentists , GingivectomyABSTRACT
Introduction: The gingival smile is one of the most common complaints related to aesthetics, having a varied etiology, its most common cause being altered passive eruption. To achieve better results, prior planning is required using photographs, plaster models, diagnostic waxing, allowing anticipation of the results without performing surgery. Objective: to report a clinical case of gingival smile correction through gingivectomy and osteotomy without flap displacement, assisted by a surgical guide, to assess the degree of postoperative pain and the impact of this treatment on the quality of life of the patient. Case report: A female patient presented a flat, thick periodontal biotype with a wide range of keratinized mucosa, short and square clinical crowns, a flat cervical line and gingival exposures greater than 3.0 mm, with no loss of insertion, establishing a ratio of 80% in the width / length ratio of crowns to their surgical planning. Results: After 60 days of surgery, the increase of the elements was as planned, and the periodontal tissues presented regular contours, cervical line of the convex smile, zinith of the canines and central incisors positioned more apically and distal to the lateral incisors. Conclusion: The surgical correction of the gingival smile by the gingivectomy technique with osteotomy without flap displacement had a positive impact on the quality of life of the patients in this study, generating a mild discomfort only in the first five hours postoperatively (AU)
Introdução: O sorriso gengival é uma das queixas mais comuns relacionada a estética, possuindo uma etiologia variada, sendo sua causa mais comum a erupção passiva alterada. Para melhor êxito nos resultados, é necessário um planejamento prévio utilizando de fotografias, modelos de gesso, enceramento diagnóstico, possibilitando antecipação dos resultados sem a realização cirurgica. Objetivo: relatar um caso clínico de correção de sorriso gengival por meio de gengivectomia e osteotomia sem deslocamento de retalho, auxiliada por um guia cirúrgico, avaliar o grau de dor no pós-operatória e o impacto deste tratamento na qualidade de vida da paciente. Relato de caso: Paciente do sexo feminino apresentava biótipo periodontal plano e espesso com larga faixa de mucosa ceratinizada, coroas clínicas curtas e quadradas, linha cervical plana e exposição gengival maior que 3,0 mm, com inexistência de perda de inserção, estabelecendo uma proporção de 80% na relação largura/comprimento das coroas para seu planejamento cirúrgico. Resultados: Após 60 dias da cirurgia o aumento dos elementos foi conforme ao planejado, e os tecidos periodontais apresentaram contornos regulares, linha cervical do sorriso convexa, zênites gengivais dos caninos e incisivos centrais posicionados mais apicalmente e para distal em relação aos incisivos laterais. Conclusão: A correção cirúrgica do sorriso gengival pela técnica de gengivectomia com osteotomia sem deslocamento de retalho impactou positivamente na melhora da qualidade vida da paciente deste estudo, gerando um leve desconforto somente nas cinco primeiras horas do pós-operatório. (AU)