Altered Passive Eruption: Treatment Modalities

Introduction: Facial aesthetics is in great demand. One's smile forms an indispensable component of aesthetics. Excessive gingival display while smiling affects the aesthetics adversely. Altered passive eruption is often a cause for it. The treatment modality to be adopted is influenced by various factors, such as the position of the cemento-enamel junction, the distance between the cemento-enamel junction and alveolar crest, lip position, maxillary skeletal hyperplasia, etc. Objective: To improve the aesthetics in patients with altered passive eruption Materials and methods: Two patients reported to the Department of Periodontics, PGIDS, Rohtak with a chief complaint of "gummy smile". In case I, upon clinical and radiographic examination, a gingival display of 10mm and short clinical crown length of 8 mm with hypermobile upper lip were observed. Internal bevel gingivectomy with lip repositioning were done under local anaesthesia. In case II, clinical and radiographic examination revealed a gingival display of 9 mm, crown length 8mm with normal lip length and maxillary position and a positive frenal pull. Internal bevel gingivectomy with osseous reduction and frenectomy were performed under local anaesthesia. Results: In both the cases, 10mm of clinical crown length was achieved. At 1 ,3, and 6 months' follow up, the crown length was maintained and a proper smile line was achieved. Conclusion: Periodontal plastic surgery led to successful treatment of altered passive eruption. Correct case selection is of paramount importance for the positive outcome of the treatment. Keywords: Altered Passive Eruption