Orthodontic management of uneven gingival margins in patients with healthy or reduced periodontium to improve smile aesthetics

Abstract Uneven gingival margins may cause visible asymmetries during smiling and may reflect alterations in the tooth shape and morphology, particularly in cases requiring restorative procedures. Despite being perceived as a minor health condition, presence of uneven gingival margins usually impacts the smile aesthetics and could affect the individual's appearance, self‐esteem, and overall quality of life, especially in subjects with a high smile line. Uneven gingival margins may result from different causes, which makes an accurate diagnosis fundamental for its treatment planning. Orthodontic treatment often serves as a conservative approach for leveling these margins, by achieving the most appropriate tooth position. This article reviews the rationale, differential diagnosis, and clinical management of uneven gingival margins using orthodontic tooth movements, providing insights for orthodontists, periodontists, and restorative dentists on the interdisciplinary care needed to correct this condition, and hence, to improve the subject's smile aesthetics.