{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T20:52:10Z","timestamp":1781988730008,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":105,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Case Reports in Dentistry"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Managing excessive gingival display (EGD) is challenging and requires precise diagnosis and etiology\u2010driven treatment for long\u2010term stability. This report describes a digitally guided, staged approach combining esthetic crown lengthening (ECL) and lip repositioning (LR) for multifactorial EGD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 28\u2010year\u2010old female presented with 7\u2009mm of gingival display on dynamic smile, upper lip length of 19\u2009mm, and lip mobility of 6\u2009mm. The etiologic diagnosis was vertical maxillary excess (VME) Class II, hyperactive upper lip (HUL), and altered passive eruption (APE) (Coslet Type 1\u2009B). Digital planning was performed using 3Shape intraoral scanning integrated with digital smile design (DSD) to establish target gingival zeniths and smile line. A dual\u2010purpose three\u2010dimensional (3D)\u2010printed surgical guide (Form 3, Formlabs) was designed to (1) control the apical extent of crown lengthening and (2) visualize the anticipated dynamic lip line, targeting a residual gingival display of 2\u20133\u2009mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management and Outcome<\/jats:title>\n                    <jats:p>Phase 1 involved ECL with gingivectomy and osseous recontouring to reestablish biologic width and create ideal crown proportions. After 6\u2009weeks of healing, LR was performed following Bhola\u2019s technique with a partial\u2010thickness mucosal excision, selective myectomy, and deep horizontal mattress sutures for stabilization. Gingival display reduced from 7\u2009mm at baseline to 0\u2009mm at 3\u2009months, and measured ~2\u20133\u2009mm after 5\u2009years of follow\u2010up, maintaining a pleasing smile arc and high patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A digitally guided staged approach integrating ECL and LR effectively managed combined EGD etiology. The 3D\u2010printed guide enhanced surgical precision and predictability, with sustained esthetic improvement at 5\u2009years and minor recurrence (2\u20133\u2009mm).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crid\/7330406","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T07:57:52Z","timestamp":1776326272000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Outcome of Guided Crown Lengthening and Lip Repositioning in the Treatment of Excessive Gingival Display"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8208-4855","authenticated-orcid":false,"given":"Hytham N.","family":"Fageeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.5125\/jkaoms.2021.47.1.3"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-0707.92599"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2021.01.005"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40902-025-00467-8"},{"key":"e_1_2_12_5_2","first-page":"352","article-title":"Altered Passive Eruption (APE) and Active Secondary Eruption (ASE): Differential Diagnosis and Management","volume":"12","author":"Ahmad I.","year":"2017","journal-title":"The International Journal of Esthetic Dentistry"},{"key":"e_1_2_12_6_2","first-page":"24","article-title":"Diagnosis and Classification of Delayed Passive Eruption of the Dentogingival Junction in the Adult","volume":"70","author":"Coslet J. 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