Comparing Two Techniques to Treat Gummy Smile Patients: Flapless Piezo-surgery Versus Conventional Open Flap Surgery.

The goal of this clinical trial is to compare and evaluate the effectiveness of conventional surgery and Piezo-surgery for the treatment of gummy smile. The main question it aims to answer: "Which of these treatment modalities (conventional open flap crown lengthening with rotary handpiece and Flapless crown lengthening with Piezoelectric ultrasound has the best clinical results with least morbidity and least relapse in treatment of gummy smile?" Researchers will compare: The primary outcome was the decrease in excessive gingival display by measuring the length of clinical crown and width of keratinized gingiva before and after treatment modalities. The The secondary outcome was to measure the durability and possibility of relapse over 6 months after treatment with high patient satisfaction

Inclusion Criteria: 1. Patient's age ranges from 20 to 40 years old. 2. Both genders were included. 3. Medically free individuals. (according to Cornell medical index) 4. Patients with gingival smile due to APE 1B in at least 3 maxillary teeth (central incisors, lateral incisors, canines, or premolars). 5. Bone thickness type: (thin to moderate). 6. No clinical attachment loss Exclusion Criteria: 1. Alcoholics and smokers. 2. Patients with systemic illnesses or disorders that compromise wound healing. 3. Patients on medications causing gingival enlargement. 4. Pregnant women or lactating mothers. 5. Patients with orthodontic appliances at the time of the surgery