This report describes the bone reduction guide which was digitally obtained to improve diagnosis, treatment outcome and follow-up. Treatment of gingival smiles due to altered passive eruption should include interdisciplinary planning and smile design to facilitate the prediction of treatment outcome. Crown lengthening surgery can be supported by digital tools to improve surgical planning and follow-up. A 30-year-old female patient was referred to a private dental clinic seeking solutions for her gingival smile. Based on the anatomical crown length, a smile design was created, and the patient was presented with a simulated smile before treatment. In the surgical phase, a full-thickness flap was raised in the upper jaw to achieve the desired outcome. Using cone-beam computed tomography to determine cementoenamel junction for smile design and treatment planning brings many benefits. Patients and clinicians can foresee treatment results. From there, appropriate changes can be made. The bone reduction guide is designed to rest on the bone to help the clinician cut the bone accurately and thoroughly follow the established plan.

Objectives: This study investigated the use of artificial intelligence (AI) in the design of lingual bracket indirect bonding trays and its association with bracket transfer accuracy using three-dimensional (3D) printing. Methods: Digital impressions of patient’s dental arches were captured using an intraoral scanner, and orthodontic setups were virtually constructed. Brackets were virtually positioned in their ideal locations using the digital setups guided by virtual archwire templates. Indirect bonding trays were automatically generated using the AI-powered Auto Creation function of the Medit Splints application, which analyzes anatomical features to streamline design. Bracket transfer accuracy was evaluated in vivo by comparing planned and actual bracket positions across grouped and individual tray configurations. Linear and angular deviations were measured using conventional 3D inspection software. Results: Most bracket transfer errors were within clinically acceptable thresholds, although torque accuracy remained suboptimal. Grouped trays generally exhibited greater precision than individual trays in several dimensions. Conclusions: These findings support the application of AI-assisted design tools to enhance digital workflows and improve consistency in appliance fabrication.

A smile that reveals >4 mm of gum tissue is called a gummy smile (GS), offering negative impacts on people's self-confidence and aesthetic appearance. The treatment for GS should be planned according to underlying causes such as altered passive eruption of teeth, dentoalveolar extrusion, vertical maxillary excess, and short or hyperactive lip muscles. In this case report, a patient with severe GS received orthodontic and gingivoplasty treatment, aided by digital tools such as 3D simulation, smile design, and 3D printed guides. The treatment yielded remarkable and satisfactory results, without the need for extensive surgery. Our findings suggest that gingivoplasty is a minimally invasive, time-and cost-effective alternative to more extensive procedures for correcting severe gum recession.

The advent of Mini-screws assisted rapid palatal expansion (MARPE) has introduced a simpler in-office procedure that enables the translation of the alveolar process in adults. This case report showed the combination of MARPE, orthodontic treatment, and gingivoplasty to correct malocclusion and enhance smile aesthetics. A 20-year-old woman expressed concerns about excessive buccal corridors and a gummy smile. She exhibited skeletal class I malocclusion, with buccal corridors exceeding 4 mm, a gummy smile, and lingual tipping of the lower posterior segments. The treatment plan involved utilizing the MARPE appliance, a Nitinol wire, gingivoplasty to address the gummy smile. Retention evaluations demonstrated the stability of MARPE in transversal skeletal discrepancies. There was notable improvement in incisor inclination and soft tissue profile, particularly evident in the E-line and nasolabial angle. Cephalometric analysis confirmed these changes, showing a decrease of 5.9 degrees in the inclination of the maxillary incisors. After a 2-year follow-up, the results remain stable, and the patient expresses satisfaction with the outcome. MARPE can be considered as an effective tool for managing buccal corridors, complemented by fixed orthodontic treatment employing labial appliances and gingivoplasty to correct malocclusion and enhance smile aesthetics. The treatment showed positive long-term outcomes.

Objective: This study aims to evaluate the clinical transfer accuracy of partially enclosed single hard vacuum-formed trays based on three-dimensional (3D) printed models for lingual bracket indirect bonding. Materials and methods: Thirty-two consecutive patients receiving lingual orthodontic treatment were enrolled. Digital models with ideal bracket positions were 3D-printed, followed by fabrication of partially enclosed single hard vacuum-formed trays. Digital impressions captured actual bracket positions and were compared to the ideal positions. One-tailed t-tests assessed if errors were within clinically acceptable thresholds of 0.5 mm for linear measurements and 2° for angular measurements. Results: Mean bracket transfer errors were 0.052 mm, 0.076 mm, 0.106 mm, 0.795°, 1.344°, and 2.485° for mesiodistal, buccolingual, occlusogingival, rotation, tip, and torque, respectively. Transfer errors were statistically below the clinically acceptable thresholds for all dimensions except torque. Frequencies of acceptable transfer errors were 100%, 100%, 99.3%, 93.1%, 78.3%, and 54.0%, respectively. Conclusion: Partially enclosed single hard vacuum-formed trays with 3D-printed models transfer lingual brackets with high accuracy in the mesiodistal, buccolingual, and occlusogingival dimensions, rotation, and tip. However, the transfer of torque remains questionable.