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Gingivoplasty and Gingival Recontouring for Anterior Aesthetic Smile Enhancement (#13–#23)

Surgical Procedure

Chief Complaint

Patient requested improvement in gum line symmetry and smile aesthetics due to excessive and uneven gingival display in the upper anterior region.

Clinical Findings

  • Presence of gingival hyperplasia on both buccal and palatal aspects from #13 to #23

  • Uneven gingival margins affecting:

    • Gum line symmetry

    • Gingival zenith position

    • Tooth height-to-width ratio

Anterior gingival contour affecting overall smile harmony

Treatment Plan

  1. Phase 1

  • Gingivoplasty and recontouring of hyperplastic gingival tissue on buccal and palatal aspects of #13–#23

  • Establish balanced gingival zeniths and improved tooth proportions

  • Anterior teeth addressed first to optimise overall symmetry

  1. Phase 2 (Planned)

  • Gingivoplasty for upper posterior teeth after adequate anterior soft tissue healing

Review and refine anterior gingival contours if required following initial healing

Pre-operative Assessment

  • Pre-operative photographs taken

  • Treatment objectives, sequencing, and expected outcomes discussed

  • Risks and procedures explained in detail

  • Patient demonstrated understanding and was agreeable to proceed

  • Informed consent obtained

Anesthesia

  • Topical anaesthesia applied

Local anaesthetic infiltration administered from #14 to #24

Surgical Procedure

  • Patient cleaned and draped under sterile conditions

  • Periodontal probing performed to assess sulcus depth

  • Desired gingival margin and contour marked and confirmed

  • Excess gingival tissue trimmed to planned gum line design

  • Gingivoplasty and gingival recontouring performed using:

    • #15 scalpel blade

    • Diode lasers (450 nm and 980 nm) on both buccal and palatal aspects

  • Surgical sites irrigated and cleaned with sterile normal saline

  • Vitamin E applied to treated areas

  • Hemostasis achieved

  • Post-operative instructions provided

Post-operative Assessment

  • Post-operative photographs taken

  • Surgical sites stable with satisfactory hemostasis

  • Patient advised on post-operative care

  • Chlorhexidine mouth rinse prescribed

Vitamin E capsules provided for topical application over the initial healing period

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