Altered passive eruption of the maxillary anterior teeth, a high lip line, a hypermobile upper lip, a short lip, or vertical maxillary excess can cause excessive gingival display. Clinical crowns with altered passive eruption (APE), which is defined by gingival margins incisal to the tooth cervical convexity, are shorter and squarer in shape. Stability of the periodontal tissues after esthetic crown lengthening especially in aesthetic areas, is a crucial aspect that can jeopardize the treatment outcome of the treated region before the placement of definitive restorations. The digital workflow and the introduction of digital technologies make it easier to guide dental procedures. This is how the ideas of guided dentistry and digital quality control allow results to be compared to original planning. In guided dentistry, the procedure is virtually simulated in three dimensions (3D) prior to the actual treatment, allowing the patient to see the outcome before any work is done. Scalpel gingivectomy has been recommended as the gold standard for treating excessive gingiva. Two other established tools used for gingivectomy procedures are electrosurgery and lasers. The aim of this presentation is to highlight step by step fabrication of periodontal surgical guide in esthetic crown lengthening and illustrating different surgical procedures by electrocautery, diode laser and scalpel blade.
