{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:12:06Z","timestamp":1779354726295,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Gingival excess, also referred to as excessive gingival display (EGD), represents a multifactorial esthetic concern influenced by skeletal, dental, and soft tissue factors. Conventional orthodontic or orthognathic interventions, while effective, may present increased morbidity. This prospective case series evaluates a minimally invasive, interdisciplinary approach integrating periodontal and cosmetic techniques for managing multifactorial gingival excess.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Considerations<\/jats:title>\n                    <jats:p>Twelve systemically healthy adult patients (mean gingival display: 5.3\u2009mm) diagnosed with both altered passive eruption and hyperactive upper lip were treated in a private practice using a combined single\u2010session protocol. The \u201ccombo technique\u201d involved esthetic crown lengthening, botulinum toxin\u2010A (Botox) injections, and hyaluronic acid\u2010based lip augmentation. Diagnosis and treatment planning were based on comprehensive clinical and radiographic assessments. Outcome measures included gingival display reduction, patient satisfaction, and postoperative discomfort, evaluated at 6 and 18\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The integrated \u201ccombo technique\u201d offers a minimally invasive and highly effective alternative for correcting EGD. It enables individualized treatment planning, reduces the amount of Botox needed, and results in stable esthetic outcomes with high patient satisfaction and minimal postoperative discomfort. This interdisciplinary approach provides a predictable and long\u2010lasting solution for complex GS cases in patients unwilling or unsuitable for orthognathic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70113","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:35:57Z","timestamp":1768912557000},"page":"1125-1139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Combo Strategy: Triple Approach for Gummy Smile\u201418\u2010Month Case Series"],"prefix":"10.1111","volume":"38","author":[{"given":"Alain","family":"Romanos","sequence":"first","affiliation":[{"name":"Department of Periodontology University of Alabama, Birmingham School of Dentistry  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5140-5604","authenticated-orcid":false,"given":"Layal Bou","family":"Semaan","sequence":"additional","affiliation":[{"name":"Department of Periodontology University of Alabama, Birmingham School of Dentistry  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7058-2283","authenticated-orcid":false,"given":"Chirine","family":"Malak","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Laboratory Doctoral School of Science and Technology, AZM Center for Biotechnology  Tripoli Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussein","family":"Basma","sequence":"additional","affiliation":[{"name":"Department of Periodontology University of Alabama, Birmingham School of Dentistry  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7745-5957","authenticated-orcid":false,"given":"Georgios E.","family":"Romanos","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Endodontics School of Dental Medicine, Stony Brook University  Stony Brook New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1999.4.1.1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.1996.tb00179.x"},{"issue":"5","key":"e_1_2_10_4_1","first-page":"778","article-title":"Influence of Sex on the Perception of Oral and Smile Esthetics With Different Gingival Display and Incisal Plane Inclination","volume":"75","author":"Geron S.","year":"2005","journal-title":"Angle Orthodontist"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2019.12.003"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.100292"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181edc627"},{"issue":"2","key":"e_1_2_10_8_1","first-page":"102","article-title":"Gummy Smile and Short Tooth Syndrome\u2014Part 1: Etiopathogenesis, Classification, and Diagnostic Guidelines","volume":"37","author":"Pavone A. 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