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A smile is a symbol of beauty and wellbeing in our modern society, human facial expression transcending language, culture, race, gender, time, and socioeconomic differences. An esthetic smile consists of three main components: the teeth, the lip framework, and the gingival scaffold. In some patients, the altered relationship between the teeth, the alveolar bone, and the soft tissue may result in the clinical condition known as gummy smile. A single factor or a combination of factors may be present in patients with this clinical condition, including altered passive eruption (APE), vertical maxillary excess, and a short or hyperactive upper lip. The present article reports on a 31-year-old female patient who presented for a consultation. The patient, who was in good general health with no significant medical history, was dissatisfied with her tooth esthetics. She had symmetric facial features with a long face appearance, retruded chin, protruded maxillary incisors, and excessive gingival display that indicated evident APE. In particular, the present case report aims to describe a multidisciplinary treatment involving a phase of orthodontics associated with maxillofacial surgery, and the periodontal surgical sequence of esthetic crown lengthening for the treatment of APE.

Maxillary expansion is a common orthodontic treatment used for the correction of posterior crossbite resulting from reduced maxillary width. Transverse maxillomandibular discrepancies are a major cause of several malocclusions and may be corrected in different manners, in particular, the rapid maxillary expansion (RME) performed in the early mixed dentition has now become a routine procedure in orthodontic practice. The aim of this study is to propose a procedure that reduces the patient cooperation as well as the lab work required in preparing a customized Haas-inspired rapid maxillary expander (HIRME) that can be anchored to deciduous teeth and can be utilized in mixed dentition with tubes on the molars and hooks and brackets on the canines. This article thus presents an expander that is completely digitally developed, from the first moment of taking the impression with an optical scanner to the final solidification phase by the use of a 3D printer. This digital flow takes place in a CAD environment and it starts with the creation of the appliance on the optical impression, this design is then exported as an stl extension and is sent to the print service to obtain a solid model of the device through a laser sintering process. This &ldquo, rough&rdquo, device goes through a post-processing procedure, finally, a commercial expansion screw is laser-welded. This expander has all the advantages of a cast-metal Haas-type RME that rests on deciduous teeth, moreover, it has the characteristic of being developed with a completely digitized and individualized process, for the mouth of the young patient, as well as being made completely of cobalt-chrome, thus ensuring greater adaptability and stability in the patient&rsquo, s mouth.