Piezoelectric-assisted Flapless Technique associated with esthetic rehabilitation: a case report

Abstract

ABSTRACT The esthetics of the smile depends on the harmony between teeth and periodontal tissues, with clinical crown lengthening being an essential strategy in cases of dental disproportions and excessive gingival display. This case report describes the application of the flapless technique, assisted by piezoelectric ultrasound and diamond tips produced by chemical vapor deposition, in a female patient dissatisfied with dental wear, tooth color, and tooth shape. The study was approved by the research ethics committee under protocol number 94187425.1.0000.0095. After clinical and tomographic evaluation, digital planning was performed, followed by the fabrication of a mock-up and a surgical guide for minimally invasive gingivoplasty and osteotomy. The flapless approach allowed precise reduction of the alveolar crest without flap elevation, preserving soft tissues, reducing surgical time, and promoting lower postoperative morbidity. After 30 days, adequate healing, gingival margin stability, and absence of inflammation were observed. Subsequently, dental preparations and the fabrication of lithium disilicate ceramic laminates restored tooth shape, color, and proportion. The outcome demonstrated harmonious integration between periodontal tissues and restorations, reestablished masticatory function, and high patient satisfaction. This case reinforces that the flapless technique associated with piezosurgery constitutes a minimally invasive, safe, and predictable approach for periodontal management in esthetic rehabilitations, providing long-lasting esthetic outcomes and increased patient comfort, in accordance with current evidence on conservative and predictable strategies in esthetic dentistry.