Bridging Gaps and Enhancing Smile: A Multidisciplinary Approach

Abstract

Introduction: Dental aesthetics significantly influence facial harmony and self-confidence. Gingival hyperpigmentation, high labial frenum attachment, midline diastema, and asymmetrical gingival zenith are common aesthetic concerns. Addressing these issues requires a multidisciplinary treatment approach combining periodontal surgical interventions and restorative procedures. Objective: This case report presents a comprehensive treatment plan involving frenectomy, gingival depigmentation, gingivoplasty, and veneer placement to enhance dental aesthetics and smile harmony. Methodology: A 22-year-old female patient presented with gingival hyperpigmentation, papilla penetrating labial frenum with midline diastema, and asymmetrical gingival zenith in upper anterior teeth region. The treatment plan included: Frenectomy using the paralleling technique to address the high frenum attachment. Gingival depigmentation using a scalpel technique combined with Vitamin E gel and platelet-rich fibrin (PRF) membrane application on contralateral quadrant to accelerate healing and less discomfort. Healing assessments were conducted at 15 and 45 days post-treatment using methylene blue staining and the Landry healing index. Gingivoplasty to achieve symmetrical gingival zenith followed by veneer placement with digital impressions, 3D-printed mock-ups, and lithium disilicate restorations for diastema closure. Conclusion: The multidisciplinary approach effectively enhanced the patient's dental aesthetics, achieving successful diastema closure, normal color and contour of gingiva. This comprehensive approach enhanced the patient's smile, reinforcing the value of tailored treatment strategies in achieving optimal periodontal health and aesthetics.