case_images: PMC7171666_01
case_images: Initial smile.
case_images: CRID2020-7923842.001.jpg
case_images: PMC7171666_01_CRID2020-7923842.001.jpg
case_images: fig1
case_images: A 19-year-old woman (M.K.S.) with leukoderma sought clinical service dissatisfied with the aesthetics of her smile due to excessive gingival exposure (Figures 1 and 2).
case_images: Initial smile, approximate view.
case_images: CRID2020-7923842.002.jpg
case_images: PMC7171666_01_CRID2020-7923842.002.jpg
case_images: fig2
case_images: A 19-year-old woman (M.K.S.) with leukoderma sought clinical service dissatisfied with the aesthetics of her smile due to excessive gingival exposure (Figures 1 and 2).
case_images: (a) Initial smile. (b) Digital waxing.
case_images: CRID2020-7923842.003.jpg
case_images: PMC7171666_01_CRID2020-7923842.003.jpg
case_images: fig3
case_images: Based on the face-guided intraoral planning analysis, digital wax-up was prepared (Figure 3).
case_images: (a) Periodontal analysis and digital planning of the guide. (b) Printed surgical guide.
case_images: CRID2020-7923842.004.jpg
case_images: PMC7171666_01_CRID2020-7923842.004.jpg
case_images: fig4
case_images: The surgical guide was designed in the same software, according to the waxing of the new gingival margin position, and printed on resin (PerioGuide) (Figures 4(a) and 4(b)), with 1 mm thickness.
case_images: Surgical guide in the mouth. The superior contour of the guide denoted a measurement of 3.0 mm above the new position of the gingival margin defined by the aesthetic waxing.
case_images: CRID2020-7923842.005.jpg
case_images: PMC7171666_01_CRID2020-7923842.005.jpg
case_images: fig5
case_images: The superior contour of the guide denoted a measurement of 3.0 mm above the new position of the gingival margin defined by the aesthetic waxing, aiming to reestablish biological distances (Figure 5).
case_images: (a) CEJ was located. (b) Primary internal bevel incision.
case_images: CRID2020-7923842.006.jpg
case_images: PMC7171666_01_CRID2020-7923842.006.jpg
case_images: fig6
case_images: Using a millimeter probe (Hu-Friedy, Chicago, USA), the CEJ was located and compared with the delimitation of the surgical guide positioned in the mouth (Figures 6(a)). The primary internal bevel incision was performed with a 15C blade (Figure 6(b)) (Swann-Morton, England), followed by intrasulcular incisions for collar removal (Figures 7(a) and 7(b)).
case_images: (a) Gingival collar removal. (b) Gingival collar removed.
case_images: CRID2020-7923842.007.jpg
case_images: PMC7171666_01_CRID2020-7923842.007.jpg
case_images: fig7
case_images: The primary internal bevel incision was performed with a 15C blade (Figure 6(b)) (Swann-Morton, England), followed by intrasulcular incisions for collar removal (Figures 7(a) and 7(b)).
case_images: Specific insertion for tunneled osteotomy with the piezoelectric device, where the cut is only at the tip to avoid damage to the tooth root.
case_images: CRID2020-7923842.008.jpg
case_images: PMC7171666_01_CRID2020-7923842.008.jpg
case_images: fig8
case_images: Also, a slight inclination of the insert is made so that it touches the bone (Figure 8).
case_images: Tunneled osteotomy with a piezoelectric.
case_images: CRID2020-7923842.009.jpg
case_images: PMC7171666_01_CRID2020-7923842.009.jpg
case_images: fig9
case_images: Its tips measuring 3 mm were inserted into the gingival sulcus to reestablish biologic width (Figure 9).
case_images: 60 days after surgery.
case_images: CRID2020-7923842.010.jpg
case_images: PMC7171666_01_CRID2020-7923842.010.jpg
case_images: fig10
case_images: In the immediate postoperative period, the patient presented better gingival contour and was completely satisfied with the treatment at the 60-day evaluation (Figure 10).