| Summary: | <p><strong>Introduction</strong>: A gummy smile is usually seen when gingival exposure more than 3 mm is visible. Esthetic crown lengthening may include a variety of surgical techniques for the gummy smile treatment, all of which aim to improve the esthetic appearance of teeth and gingiva. Crown lengthening is a surgical procedure aimed at removal of periodontal tissue to increase the clinical crown height.</p><p><strong>Case: </strong>A 21-year-old woman was referred to the Prof. Soedomo Dental Hospital. The patient presented good general health and anterior maxillary teeth with short clinical crowns. There was no periapical radiolucency at radiographic. Gingival exposure was 6 mm. Preoperative intraoral examination showed healthy gingiva, and the clinical crown ratio was about 1:1. At clinical examination, periodontal pocket depth was 3 mm or less, and bone sounding was 3.5 mm or less. After determining the problem, esthetic crown lengthening surgery was performed under local anesthesia. Chu’s aesthetic gauge ratio used to measure ideal clinical crown ratio allowed gingivectomy. Mucoperiosteal flap raised after incision followed by ostectomy to maintain biological width. The flap was repositioned and sutured with various suture technique. Frenototomy was performed to release flap tension, and periodontal dressing was applied after frenotomy. Intraoral examination in 3 months follow up showed reduced gingival exposure to 3 mm and ideal clinical crown ratio.</p><p><strong>Conclusion: </strong>The esthetic crown lengthening with ostectomy and frenotomy for treatment of gummy smile was successful to reduced gummy smile and reach ideal clinical crown ratio.</p>
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