Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. 1g Adequate gingival position, but with slightly inflamed papilla between teeth #8 and #9. 1e Gingival margin stabilized with mattress sutures.Ĭase 2. This article compares and contrasts altered passive eruption (APE) and active secondary eruption (ASE) and highlights the treatment similarities and.
#Altered passive eruption full
1d Proximity between alveolar crest and the CEJ after full thickness flap elevation. 1c Gingival aspect after gingival collar removal.Ĭase 2. Lines 64-67: the authors stated that as to their knowledge, there are no histological studies on this topic. 1b Internal bevel incision with angulation of 45 degrees in relation to tooth long axis due to gingival thickness.Ĭase 2. Since this study focuses on gingivas histological aspects in patients with altered passive eruption, I suggest a brief description of gingivas normal histology be included in the introduction section. 1a Intraoral initial view demonstrating short clinical crowns with wide and thick keratinized gingiva.Ĭase 2. Clinical cases and schemes enable understanding and treatment planning of different conditions.Ĭase 2. Periodontal biotypes are also taken into consideration.Ĭonclusions: This article proposes modification of a previous classification dealing with two eruptive processes known as AAE and APE. This article proposes a modification of a previous clinical classification and provides a surgical guide for treatment planning of cases involving APE and/or AAE. Thus, correct understanding of biologic events related to APE and AAE should be considered in the classification of a gummy smile. Altered active eruption (AAE) occurs when teeth achieve the opposite relationship to the occlusal plane prematurely and the osseous crest is on or very close to the cemento-enamel junction. Active eruption is defined as tooth movement in the occlusal direction as the tooth erupts from its osseous crypt. APE is a genetic or developmental condition characterized by coronal positioning of the gingival margin over enamel, resulting in short clinical crowns. Summary: Frequently, a “gummy smile” contributes to esthetic problems and is caused by several factors such as vertical maxillary growth, dentoalveolar extrusion, short upper lip, upper lip hyperactivity, altered passive eruption (APE), or a combination of these factors. Focused Clinical Question: How should cases of altered passive and active eruption be diagnosed, classified, and treated?
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