{"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":1779354726355,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"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>Objectives<\/jats:title>\n                    <jats:p>This study evaluated the clinical outcomes, surgical accuracy, and patient satisfaction in treating excessive gingival display caused by altered passive eruption (APE) using a comprehensive digital workflow and double surgical guide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      A prospective case series study was conducted enrolling 30 patients diagnosed with APE Type 1B. Cone\u2010beam computed tomography (CBCT), intraoral scanning, and digital smile design were used to design and fabricate a 3D\u2010printed double surgical guide for both gingivectomy and osteotomy. The primary outcome was surgical accuracy, assessed by the gingival margin relapse at 6\u2009months. Secondary outcomes included gingival display (GD), clinical crown length (CCL), periodontal and papillary parameters, and patient satisfaction. Statistical analyses were performed with significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty participants were treated successfully. The digital workflow demonstrated high accuracy with a median gingival margin relapse of 0.69 [0.58\u20130.87] mm at 6\u2009months. Regarding clinical efficacy, a statistically significant reduction in GD was observed (from 3.13 [2.90\u20133.85] to 1.06 [0.56\u20131.99] mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) alongside a statistically significant increase in CCL (from 7.64 [7.25\u20138.16] to 10.00 [9.56\u201310.46] mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patient\u2010reported outcomes indicated 100.0% satisfaction with the esthetic result.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within the limitations of this case series, the described comprehensive digital workflow using a double surgical guide is a predictable and effective method for treating excessive gingival display. The technique achieves significant esthetic improvements and results in a high level of patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>This study presents a comprehensive digital workflow for the treatment of gummy smile caused by altered passive eruption. By integrating digital planning with a double surgical guide, clinicians can achieve precise soft and hard tissue management, leading to predictable esthetic outcomes and high patient satisfaction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70123","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:27:57Z","timestamp":1771226877000},"page":"1154-1165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Comprehensive Digital Workflow for the Treatment of Excessive Gingival Display Caused by Altered Passive Eruption: A Prospective Case Series"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3958-5149","authenticated-orcid":false,"given":"Nguyen Trong","family":"Tinh","sequence":"first","affiliation":[{"name":"Department of Oral Surgery, Faculty of Dentistry Van Lang University  Ho Chi Minh Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huynh Nhat","family":"Duy","sequence":"additional","affiliation":[{"name":"Faculty of Odonto\u2010Stomatology Can Tho University of Medicine and Pharmacy  Can Tho Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le Ngoc Thanh","family":"Ngan","sequence":"additional","affiliation":[{"name":"Faculty of Odonto\u2010Stomatology Can Tho University of Medicine and Pharmacy  Can Tho Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7175-4155","authenticated-orcid":false,"given":"Tran Huynh","family":"Trung","sequence":"additional","affiliation":[{"name":"Faculty of Odonto\u2010Stomatology Can Tho University of Medicine and Pharmacy  Can Tho Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5555-464X","authenticated-orcid":false,"given":"Nguyen Thu","family":"Tra","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, School of Dentistry Hanoi Medical University  Hanoi Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1073-8746(96)80036-3"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2019.12.003"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.2059"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.13041"},{"issue":"3","key":"e_1_2_12_6_1","first-page":"24","article-title":"Diagnosis and Classification of Delayed Passive Eruption of the Dentogingival Junction in the Adult","volume":"70","author":"Coslet J. G.","year":"1977","journal-title":"Alpha Omegan"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12206"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.120162"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/app10165697"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jds.2023.06.007"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12920"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.4047\/jap.2014.6.5.395"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.33805\/2572-6978.140"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2020.09.041"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2019.06.027"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.13405"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2023.104711"},{"issue":"3","key":"e_1_2_12_18_1","first-page":"212","article-title":"Treatment of Altered Passive Eruption: Periodontal Plastic Surgery of the Dentogingival Junction","volume":"3","author":"Rossi R.","year":"2008","journal-title":"European Journal of Esthetic Dentistry"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1961.32.3.261"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-023-05458-5"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-022-04780-8"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17-0733"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04158-0"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04080-5"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-020-03239-y"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.13487"},{"issue":"12","key":"e_1_2_12_27_1","first-page":"e51040","article-title":"An Analysis of the Esthetic Proportions of Anterior Maxillary Teeth in a School of Dentistry in Ar Rass","volume":"15","author":"Omran M.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12482"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3913(12)60009-2"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sdentj.2023.03.004"},{"issue":"1","key":"e_1_2_12_31_1","first-page":"17","article-title":"Smile Line and Periodontium Visibility","volume":"1","author":"Li\u00e9bart M. F.","year":"2004","journal-title":"Periodontal Practice Today"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/19424396.2007.12221250"},{"issue":"6","key":"e_1_2_12_33_1","first-page":"363","article-title":"Altered Passive Eruption: An Etiology of Short Clinical Crowns","volume":"28","author":"Dolt A. H.","year":"1997","journal-title":"Quintessence International"},{"issue":"1","key":"e_1_2_12_34_1","first-page":"13","article-title":"\u0110\u1eb7c \u0110i\u1ec3m H\u00ecnh Th\u00e1i C\u1ee7a Ph\u1ee9c H\u1ee3p R\u0103ng N\u01b0\u1edbu V\u00e0 M\u1ee9c \u0110\u1ed9 T\u1ee5t Gai N\u01b0\u1edbu C\u1ee7a V\u00f9ng R\u0103ng Tr\u01b0\u1edbc H\u00e0m Tr\u00ean","volume":"520","author":"Quang Khi\u00eam \u0110.","year":"2023","journal-title":"T\u1ea1p Ch\u00ed Y H\u1ecdc Vi\u1ec7t Nam"},{"key":"e_1_2_12_35_1","first-page":"100059","article-title":"Positional Stability of the Periodontal Tissues Following Crown Lengthening Surgery","volume":"2","author":"Altayeb W.","year":"2022","journal-title":"Dental\u2010Revue"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/7234310"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2019.08.011"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-019-0851-0"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13573"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.1926"}],"container-title":["Journal of Esthetic and Restorative Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.70123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jerd.70123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.70123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:52:42Z","timestamp":1779353562000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jerd.70123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,15]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/jerd.70123"],"URL":"https:\/\/doi.org\/10.1111\/jerd.70123","archive":["Portico"],"relation":{},"ISSN":["1496-4155","1708-8240"],"issn-type":[{"value":"1496-4155","type":"print"},{"value":"1708-8240","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,15]]},"assertion":[{"value":"2025-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}