case_images: PMC6712968_01
case_images: Face photograph.
case_images: CRID2019-1230610.001.jpg
case_images: PMC6712968_01_CRID2019-1230610.001.jpg
case_images: fig1
case_images: I occlusion, but with an uneven occlusal plane and dental elements with alterations in color, size, shape, incisal wear, and gingival zenith. Initially, dental impressions from both dental arches (performed with the addition of silicone rubber; Virtual, Ivoclar Vivadent), occlusion record, and digital smile design protocol photos (DSD) were used for the case planning (Figures 1-3).
case_images: Smile with lip retractors.
case_images: CRID2019-1230610.002.jpg
case_images: PMC6712968_01_CRID2019-1230610.002.jpg
case_images: fig2
case_images: I occlusion, but with an uneven occlusal plane and dental elements with alterations in color, size, shape, incisal wear, and gingival zenith. Initially, dental impressions from both dental arches (performed with the addition of silicone rubber; Virtual, Ivoclar Vivadent), occlusion record, and digital smile design protocol photos (DSD) were used for the case planning (Figures 1-3).
case_images: Approximate view of the smile.
case_images: CRID2019-1230610.003.jpg
case_images: PMC6712968_01_CRID2019-1230610.003.jpg
case_images: fig3
case_images: I occlusion, but with an uneven occlusal plane and dental elements with alterations in color, size, shape, incisal wear, and gingival zenith. Initially, dental impressions from both dental arches (performed with the addition of silicone rubber; Virtual, Ivoclar Vivadent), occlusion record, and digital smile design protocol photos (DSD) were used for the case planning (Figures 1-3).
case_images: Radiograph aspect.
case_images: CRID2019-1230610.004.jpg
case_images: PMC6712968_01_CRID2019-1230610.004.jpg
case_images: fig4
case_images: By means of radiographs, it was possible to evaluate the necessity of strategic bone removals to redefine the supracrestal space (Figure 4).
case_images: DSD planning.
case_images: CRID2019-1230610.005.jpg
case_images: PMC6712968_01_CRID2019-1230610.005.jpg
case_images: fig5
case_images: The possibility of performing this new aesthetic planning was confirmed by radiographic and clinical examinations and subsequent mock-ups (Figures 5(a)-5(c) and 6).
case_images: Surgical index.
case_images: CRID2019-1230610.007.jpg
case_images: PMC6712968_01_CRID2019-1230610.007.jpg
case_images: fig7
case_images: A surgical guide was manufactured to increase the clinical crown (gingivectomy and osteotomy) according to the parameters suggested by the virtual design (DSD) (Figure 7).
case_images: Surgical index: lateral view.
case_images: CRID2019-1230610.008.jpg
case_images: PMC6712968_01_CRID2019-1230610.008.jpg
case_images: fig8
case_images: In order to perform surgical crown lengthening (Figures 8-11), the surgical guide was used to perform the incisions and the definition of the new gingival zeniths.
case_images: Incisions with the guide.
case_images: CRID2019-1230610.009.jpg
case_images: PMC6712968_01_CRID2019-1230610.009.jpg
case_images: fig9
case_images: In order to perform surgical crown lengthening (Figures 8-11), the surgical guide was used to perform the incisions and the definition of the new gingival zeniths.
case_images: Incisions.
case_images: CRID2019-1230610.010.jpg
case_images: PMC6712968_01_CRID2019-1230610.010.jpg
case_images: fig10
case_images: In order to perform surgical crown lengthening (Figures 8-11), the surgical guide was used to perform the incisions and the definition of the new gingival zeniths.
case_images: Final aspect.
case_images: CRID2019-1230610.011.jpg
case_images: PMC6712968_01_CRID2019-1230610.011.jpg
case_images: fig11
case_images: In order to perform surgical crown lengthening (Figures 8-11), the surgical guide was used to perform the incisions and the definition of the new gingival zeniths.
case_images: Mock up with the new gingival position.
case_images: CRID2019-1230610.012.jpg
case_images: PMC6712968_01_CRID2019-1230610.012.jpg
case_images: fig12
case_images: The patient was followed up postoperatively; because the gingival margin was stable and to avoid the inflammation process, no type of temporary material was used during the healing period. 60 days after the surgical procedure, new dental impressions were obtained, diagnostic waxing was performed under the new periodontal parameters, and a new mock-up with Protemp  4 Temporization Material (3M ESPE) bisacrylic resin was realized (Figure 12).
case_images: Vestibular guide.
case_images: CRID2019-1230610.013.jpg
case_images: PMC6712968_01_CRID2019-1230610.013.jpg
case_images: fig13
case_images: Measurements of adequate ceramic space (between 0.3 and 0.5 mm) were checked from time to time with the aid of a periodontal probe from the dental enamel to the guide (Figures 13 and 14).
case_images: Incisal guide.
case_images: CRID2019-1230610.014.jpg
case_images: PMC6712968_01_CRID2019-1230610.014.jpg
case_images: fig14
case_images: Measurements of adequate ceramic space (between 0.3 and 0.5 mm) were checked from time to time with the aid of a periodontal probe from the dental enamel to the guide (Figures 13 and 14).
case_images: Final aspect of dental preparation.
case_images: CRID2019-1230610.015.jpg
case_images: PMC6712968_01_CRID2019-1230610.015.jpg
case_images: fig15
case_images: Care should be taken to keep the tooth reduction inside the thickness of the enamel (Figure 15).