One-Year Clinical Evaluation of the Horizontal Mattress Sling Suture for Aesthetic Crown Lengthening.

Introduction: In aesthetic crown lengthening (ACL) surgery, conventional suturing techniques, such as interrupted or vertical mattress sutures, involve piercing both buccal and palatal tissues. This preliminary case series introduces a new suturing approach, "the horizontal mattress sling suture" (HMSS), that eliminates the need to pierce palatal tissues and thus avoids the requirement for palatal anesthesia. Clinical Consideration: Three healthy patients with excessive gingival display sought treatment at the Department of Periodontics at the University of Jordan. ACL surgery was performed following comprehensive dental and radiographic examinations, as well as periodontal prophylaxis. The HMSS, which combines the horizontal mattress and sling suture techniques, was employed to secure the buccal flap. Follow-up visits were scheduled at 2 weeks and at 3, 6, and 12 months postsurgery. Results: All three cases showed uncomplicated healing with no adverse effects. Patients experienced manageable pain during the initial days postsurgery, readily controlled with routine analgesics. None of the patients reported any complications or expressed any concerns, and all were satisfied with the outcomes at each follow-up visit. Conclusion: HMSS, a suturing technique designed for single-flap procedures, such as ACL, is a promising approach that provides a better patient experience by avoiding the necessity to anesthetize the corresponding aspect of the oral soft tissues where a flap was not elevated.