Is it Time to Retire the Gingival Flap from Esthetic Crown Lengthening Surgery?
October 21    10:30 – 11:30

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.

The width of keratinized gingiva, the position of the gingival margins, the location of the buccal alveolar crest, the location of the mucogingival junction, and the likelihood of concomitant restorative therapy are all factors that collectively determine the esthetic crown lengthening approach.

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.

The ability of erbium lasers to ablate both hard and soft tissues with excellent surgical precision and minimal collateral effects creates the opportunity for a minimally invasive flap and flapless, resulting in decreased tissue damage, minimize the bleeding, causing less inflammation, less post-operative discomfort, and may prevents collateral tissue damage that could occur with conventional methods.

Conclusion: Laser-assisted flapless esthetic crown lengthening is a predictable procedure, less traumatic, faster uneventful wound healing, and overall a positive experience for the patients.

Learning Objectives:

  • Understanding of the classification and treatment planning for gummy smile caused by altered passive eruption..
  • Discover how to meet the esthetic parameters through crown lengthening.
  • Decide which surgical technique to apply in relation to the altered passive eruption diagnosis.
  • Utilize the erbium laser in management of crown lengthening.
  • Compare the clinical outcomes of erbium laser-assisted open-flap and flapless esthetic crown lengthening.
  • Examine the relationship between the alterations in the periodontal tissue levels after crown lengthening with the amount of osseous resection, periodontal phenotype, tooth location, and the surgical technique.
Dr. Walid Altayeb
Curriculum Vitae

Dr. Altayeb received his dental degree from Faculty of Dentistry, Damascus University in 1998. He completed his Master of Science in Periodontics in 2004 
and Doctorate ofPhilosophy PH.D in Periodontics in 2007. He achieved the Master status from the Academy of Laser Dentistry (Florida, USA) where is currently in the Board of Directors and the ALD Speakers Bureau, Treasurer 2022-2023 and President-elect for 2023-2024.
Dr. Altayeb is Guest Professor at Faculty of Dental Medicine, Istanbul Ayden University (Istanbul, Turkey) and at UNIVERSIAPOLIS The International University of Agadir, Agadir, Morocco. He is Lecturer at Università Cattolica del Sacro Cuore di Roma Master Laser Dentistry (Rome, Italy). 
Dr. Altayeb received The John G. Sulewski Distinguished Service Award / 2019 of ALD. Speaker in many conferences in Middle East, Europe, and USA in the fields of Periodontal Medicine, Implantology, and Laser Dentistry and Continuing education provider, over 1100 CPD hours in last 7 years. 
He is running “Pink Aesthetics & Laser Dentistry” courses with the British Academy of Implant and Restorative Dentistry in Middle East and North Africa. 

General Secretary of iLED 2018 and iLED 2019 conferences, Dr. Altayeb is working in private practice as periodontist and Implantologist in Doha, Qatar, and 
Dubai, UAE.