Treatment of Altered Passive Eruption: Periodontal Plastic Surgery of the Dentogingival Junction

Excessive gingival display, frequently seen in adults and resulting in short clinical crowns, has been described in the literature by several authors as "altered passive eruption." It is defined as a dentogingival relationship wherein the gingival margin is positioned coronally on the anatomic crown and does not approximate the cementoenamel junction due to the disruption in the development and eruptive patterns of the dentogingival unit. This article describes how periodontal plastic surgery can remodel the attachment apparatus, reestablish the correct biologic width, eliminate the excessive show of gingiva, and expose the correct dimensions of teeth. Apically repositioned flaps with osseous recontouring can restore gingival health and the esthetic parameters of the smile line.