Open-Flap versus FlaplessLaser-assisted Management of Excessive Gingival Display
Background: Excessive gingival display “gummy smile” seems to be one of the main esthetic feature of the periodontium that plays an important role on oral health-related quality of life and can have an adverse effect on the patient’s perception of attractiveness and self-confidence.  Altered passive eruption APE is one of the causal factors of Excessive gingival display. Esthetic crown lengthening surgery could be considered a predictable protocol for APE and achieving more harmonious and symmetrical smiles.

Clinical Implications: Esthetic crown lengthening surgery to manage APE could include gingivectomy and/or apically repositioned full-thickness flap, with/without ostectomy. Clinical application of lasers in periodontal surgery has continued to expand in the last decade and the concept of minimally invasive dentistry can be achieved by choosing laser treatment.

Conclusion: Laser-assisted aesthetic crown lengthening is a predictable procedure, less traumatic, faster uneventful wound healing, may prevent collateral tissue damage that could occurwith conventional methods. and overall a positive experience for the patients.

Learning Objectives
• Understanding of the classification and treatment planning for gummy smile.
• Explain the biologic laser tissue interaction in periodontal tissues
• Plan the periodontium preparation prior to prosthetic treatments
• Demonstrate the surgical techniques when performing esthetic crown lengthening with lasers
• Compare the clinical outcomes of  erbium laser-assisted open-flap and flapless esthetic crown