DOI: https://doi.org/10.36347/sjds.2026.v13i07.001

Pages: 110-114

Altered passive eruption (APE) is a developmental condition characterized by excessive gingival coverage of the anatomical crowns, resulting in short clinical crowns and compromised smile esthetics. Smile design aims to establish harmony between the teeth, gingiva, lips, and facial structures through individualized treatment planning. This case series describes the management of two female patients diagnosed with altered passive eruption. The first patient presented with bleeding gums, short clinical crowns, and an unaesthetic smile and was treated with phase I periodontal therapy followed by esthetic crown lengthening. The second patient presented with excessive gingival display associated with altered passive eruption and was managed with a combination of esthetic crown lengthening and lip repositioning surgery. Comprehensive smile analysis was performed in both cases to identify etiologic factors and formulate appropriate treatment plans. Both patients exhibited satisfactory healing, improved gingival architecture, enhanced crown proportions, and significant improvement in smile esthetics. These cases highlight the importance of accurate diagnosis, smile analysis, and individualized treatment planning in achieving predictable esthetic outcomes in patients with altered passive eruption.