Smile Design: From Ape To Human

Smile Design: From Ape To Human


  • Varshal J Barot


Altered passive eruption (APE), aesthetic crown lengthening, gingivectomy, gummy smile, tooth eruption


Background & Objective: The domain of periodontics has changed from being strictly a health service to one, where smile enhancement has been brought to the forefront of treatment planning. In the composition of a beautiful smile, the form, balance, symmetry and relationship of the elements make it attractive or unattractive. Altered passive eruption is one of the conditions where a large portion of the anatomic crown remains covered by the gingiva which compromises dentofacial aesthetics. Periodontal plastic procedures, such as the basic gingivectomy, osseous correction or the apically positioned flap, may be used to change the silhouette form of teeth and their relative proportion. Here is a case of a 22-year-old healthy male with altered passive eruption (type 1A) with treatment that resulted in a revised silhouette form for the tooth which is more elliptical and attractive so as to resolve the unwarranted excessive display of gingiva apparent during smiling. [Barot V NJIRM 2015; 6(4):121-124]


1. Ahmad I. Geometric considerations in anterior dental aesthetics: restorative principles. Pract Periodontics Aesthet Dent 1998;10:813-22
2. Chiche GJ, Pinault A. Esthetics of Anterior Fixed Restorations. Chicago: Quintessence Publishing; 1994:61-62.
3. Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000 1996;11:8-28.
4. Volchansky A, Cleaton-Jones PE. Delayed passive eruption. A predisposing factor to Vincent´s infection? J Dent Asso S Africa 1974;29:291-94.
5. Orban B, Kohler J. The physiologic gingival sulcus. Z Stomatol 1924;22:353.
6. Gargiulo AW, Wentz FM, Orban B. Dimensions and Relations of the Dentogingival Junction in Humans. J Periodontol 1961;32:261-67.
7. Coslet GJ, Vanarsdall R, Weisgold A. Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. Alpha Omegan 1977;10:24-8.
8. Kokich VG, Kokich VO: Interrelationship of Orthodontics with Periodontics and restorative dentistry. In: Nanda R, ed. Biomechanics and Esthetic Strategies in Clinical Orthodontics, St Louis: Elsevier: 348-73, 2005.
9. Malkinson S, Waldrop TC, Gunsolley JC, Lanning SK, Sabatini R. The effect of esthetic crown lengthening on perceptions of a patient’s attractiveness, friendliness, trustworthiness, intelligence, and self-confidence. J Periodontol 2013;84:1126-33.




How to Cite

Barot, V. J. (2018). Smile Design: From Ape To Human: Smile Design: From Ape To Human. National Journal of Integrated Research in Medicine, 6(4), 121–124. Retrieved from



Case Report