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22 I I case report _ gummy smiles more than 2 mm of gum tissue. In this case, the patient’s VI would have increased only to 15 mm, leaving her with a gummy smile even after the procedure was completed (Fig. 4). After administering a local anaesthetic, a frenectomy was performed on the patient to further release the upper lip and reduce the gum-to-teeth ratio (Fig. 5). The bite was checked again and the tem- poraries were applied. The final VI increase for the patient following the bite correction, frenectomy and gingivectomy was 6 mm, in- creasing the VI from 13 to 19 mm. While the increase could have remained at 17 mm, the ad- ditional 2 mm was an aesthetic improvement (Fig. 6). After the veneers had been applied and the gums healed, the patient showed an excep- tional reduction in her gummy smile, as well as increased gum health with proper stippling (Figs. 7a & b). _Case II A 37-year-old female patient presented with a 12 mm VI and complaints of an overly gummy smile (Fig. 8). Although her gums were healthy, she was referred to a hygienist for a thorough cleaning prior to treatment. The patient’s central incisors were 9 mm wide, while the Golden Proportion was 11.6 mm. The patient’s golden VI, therefore, was 18.8 mm, which was an increase of 6.8 mm from her cur- rent VI. Measurements of the patient’s teeth showed that the length-to-width ratio was almost identical (Fig. 9). The Myomonitor and K7 Bite Evaluation System determined that the patient’s bite could be opened to a VI of 17 mm, which was a significant increase of 5 mm from her original VI. The patient wore an orthotic for one month, after which her bite was re-checked and temporary teeth applied (Fig. 10). Soundingdeterminedthat2mmofgumtissue could safely be removed. After a frenectomy and gingivectomy utilising the diode laser, 2 mm of tissue was removed, further increasing the pa- tient’s VI to 19 mm, allowing for an exceptional correction to the gummy smile condition of 7 mm from the original 12 mm VI (Figs. 11a & b)._ Editorialnote:Acompletelistofreferencesisavailable from the publisher. cosmeticdentistry 2_2010 Dr David S.Frey has been in private practice in Beverly Hills for over 20 years.A graduate of the University of Pacific Dental School in 1989,Dr Frey’s pas- sion for learning and excellence has allowed him to establish a very high-end cosmetic and reconstructive practice. Furthermore,Dr Frey has pursued extensive training and education at the prestigious LasVegas Institute allowing him to more comprehensively evaluate his patients.He has authored two books, RevitalizeYour Smile and RevitalizeYour Mouth, and written for top US dental journals.He has appeared in People magazine for his work on celebrity idol ElliottYamin,and has made multiple appearances on the Learning Channel’s programmes TenYearsYounger and A Personal Story. cosmeticdentistry _about the author Fig. 11bFig. 11a