Gummy Smile and Altered Passive Eruption Prevalence

April 23, 2026 updated by: Fabrizio Guerra, University of Roma La Sapienza

Prevalence of Gummy Smile and Altered Passive Eruption in a Young Adult Population.

This observational epidemiological study aims to assess the prevalence of gummy smile and altered passive eruption in a young adult population, with a focus on the second sextant. Periodontal and aesthetic parameters, along with patient-reported discomfort, will be analyzed to identify potential correlations and underlying anatomical factors.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The primary aim of this study is to evaluate the prevalence of gummy smile, with particular focus on altered passive eruption, in a young adult population. Additionally, the study seeks to analyze key aesthetic and periodontal parameters in order to better understand their role in the etiology and clinical manifestation of excessive gingival display. Special attention is given to the second sextant, which is most frequently involved in gummy smile, to investigate the local distribution of these alterations and their diagnostic relevance.

Furthermore, the study aims to explore the relationship between the extent of gingival exposure and variations in periodontal parameters, while also assessing the level of aesthetic, psychological, and social discomfort perceived by affected individuals. Data analysis will also allow the identification of potential individual anatomical factors, such as the position of the mucogingival junction and clinical crown dimensions, that may be associated with altered passive eruption.

This is an observational epidemiological study designed to evaluate periodontal aesthetic parameters in patients attending their first clinical visit. The study will also assess the presence of aesthetic discomfort, investigate possible correlations, and explore the need for treatment related to second sextant conditions. Patients selected according to specific inclusion and exclusion criteria will undergo an operator-patient interview to collect anamnestic and clinical data. documentation.

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The population will include individuals with and without excessive gingival display, in order to assess the prevalence of gummy smile and its association with altered passive eruption and related anatomical and aesthetic parameters. Particular attention will be given to the second sextant, which represents the area most frequently involved in gingival display.

All participants will undergo a non-invasive clinical and photographic assessment aimed at evaluating gingival exposure, clinical crown dimensions, and other relevant anatomical features. In addition, patient-reported outcomes regarding aesthetic perception and psychosocial impact will be collected.

Description

Inclusion Criteria:

  • Male and female subjects;
  • Age between 18 and 50 years;
  • Periodontally healthy subjects;
  • Patients with no history of orthodontic treatment;
  • Patients without gingival hypertrophy or hyperplasia.

Exclusion Criteria:

  • Age < 18 or > 50 years;
  • Patients diagnosed with Stage I-IV periodontitis;
  • Patients currently undergoing orthodontic treatment;
  • Patients with severe dental crowding in the second sextant;
  • Patients taking medications associated with gingival hypertrophy or -hyperplasia;
  • Patients unwilling to provide informed consent;
  • Patients with fixed or removable prostheses in the second sextant;
  • Patients with a history of surgical procedures in the second sextant;
  • Patients with uncontrolled diabetes or neuropsychiatric disorders;
  • Patients with infectious diseases;
  • Pregnant or breastfeeding women, or those with suspected pregnancy;
  • Patients taking bisphosphonates;
  • Oncologic patients and those undergoing head and neck radiotherapy or receiving chemotherapy;
  • Patients with alcohol or drug abuse.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Healthy young adults
Young adult subjects undergoing first dental examination, evaluated for periodontal and aesthetic parameters and the presence of excessive gingival display.
Other: Clinical assessment
Non-invasive clinical evaluation including measurement of aesthetic indices (PES/WES), and intraoral photographic documentation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gingival display during smiling
Time Frame: Baseline (single visit)
Quantitative assessment of gingival display during posed smile, measured as the vertical distance (in millimeters) between the inferior border of the upper lip and the gingival margin of the maxillary central incisors. Continuous variable (mm), measured using a calibrated periodontal probe and standardized intraoral photographs.
Baseline (single visit)
Prevalence of altered passive eruption (APE)
Time Frame: Baseline
Assessment of the presence of altered passive eruption based on clinical crown dimensions and gingival margin position relative to anatomical landmarks. Measurement scale: Categorical variable (Presence/Absence)
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical crown length of maxillary anterior teeth
Time Frame: Baseline
Measurement of the clinical crown length (in millimeters) of maxillary anterior teeth, from the incisal edge to the gingival margin with a periodontal probe.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Roma La Sapienza

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2025

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

April 16, 2026

First Submitted That Met QC Criteria

April 16, 2026

First Posted (Actual)

April 23, 2026

Study Record Updates

Last Update Posted (Actual)

April 29, 2026

Last Update Submitted That Met QC Criteria

April 23, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 1972/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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