case_images: PMC11178395_01
case_images: (a) Frontal view. Note the excessive gingival display and reduced height for the anterior maxillary teeth during patient's high smile. (b) Perspective view. Note the reduced size of the patient's #9 and 10.
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case_images: fig1
case_images: (a) Frontal and (b) perspective views of the patient's smile using the mock-up. Note an esthetically pleasing smile.
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case_images: fig2
case_images: The patient's dental casts were created, and a mock-up was developed using the Digital Smile Design  protocol to achieve an esthetically pleasant dental arrangement that harmonizes with the patient's facial features (Figure 2). The surgical appointment involved using the mock-up as an esthetic stent for the crown lengthening procedure (Figure 2).
case_images: (a) Mock-up used as esthetic stent for the crown lengthening procedure planned for teeth #4-14. (b) A periodontal probe was used to assist during the bone reduction.
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case_images: fig3
case_images: Subsequently, an intrasulcular internal bevel incision (Swan Morton, UK) was made with a 15C blade (Figure 3(a)), and a collar was obtained. The golden proportions were rechecked using a periodontal probe (Figure 3(b)).
case_images: (a) Frontal view after a full-thickness flap was elevated. Note the presence of the bone at the level of the cementoenamel junction from teeth #6-11. (b) Frontal view of the bone after bone reduction was conducted. Note the presence of extensive overhang of the mesial aspect of the restorations for tooth #8.
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case_images: fig4
case_images: After flap reflection, the bone showed to be at the CEJ (Figure 4(a)). Fedi, #36/37 Rhodes chisels) and rotatory instruments were used for osteotomy and osteoplasty. Following bone reduction (Figure 4(b)), the surgical sites were thoroughly irrigated with saline solution, and the buccal flap was repositioned.
case_images: (a) Fifteen days postoperatively after the sutures were removed and the provisional restorations were placed. The patient returned for suture removal. Note the presence of slight marginal erythema, which may be expected at this follow-up period. (b) Frontal view 6 months postoperatively with the final laminate veneers.
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case_images: fig5
case_images: At the 15-day postoperative appointment, the patient received prophylaxis prior to suture removal (Figure 5(a)). The provisional restorations were placed after 90 days of healing, and the definitive restorations were cemented 6 months postoperatively using a photopolymerizing resin-luting cement (Variolink Esthetic, Ivoclar Vivadent) (Figure 5(b)).
case_images: (a) Frontal view of the patient's smile six months postoperatively. Note the esthetic smile. (b) Perspective view of the patient's smile 6 months postoperatively.
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case_images: fig6
case_images: During the six-month follow-up, the patient exhibited an esthetic smile (Figures 6(a) and 6(b)), attributed to achieving esthetic equilibrium through adhering to the golden proportion measurements for the anterior maxillary teeth. The six-month follow-up showed significant esthetic smile and stability of the tissues (Figures 6(a) and 6(b)).
case_images: (a) Preoperative frontal view of the lack of lip in repose. (b) Postoperative frontal view of the lip in repose showing the presence incisal edges of the anterior maxillary teeth.
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case_images: fig7
case_images: The patient also regained esthetic lip support before (Figure 7(a)) after the rehabilitation was completed (Figure 7(b)).