The Effect of Using Two Different Suturing Techniques on Free Gingival Marginal Stability after Esthetic Crown Lengthening for Treatment of Gummy Smile (Randomized Clinical Trial)

Abstract

Gummy smile is one of the major esthetic problems nowadays; it is due to several causes that either dental or skeletal. Etiology of the gummy smile is altered passive eruption, vertical maxillary excess, different gingival enlargement conditions, deficient maxillary lip length and excessive maxillary lip mobility, dento alveolar extrusion, combination of all these factors.

Altered passive eruption is considered to be one of the major causes of gummy smile, it is classified into two types according to the location of the mucogingival junction with respect to the bone crest and each type has two subtypes according to the relationship between the bone crest position and the CEJ position. In type 1 the gingival margin is incisal or occlusal to the CEJ, the mucogingival junction is located apical to the bone crest. In type 2 the keratinized gingival tissue is narrow, the mucogingival junction coinciding with the level of the cementoenamel junction. Both types are classified into subtypes A and B. In subtype A, the distance between the bone crest and CEJ is 1.5 – 2 mm (which allows a normal dimension of connective