This paper examines various esthetic periodontal considerations during orthodontic treatment. The management of excessive gingival display caused by altered passive eruption is reviewed, with emphasis on causes, recognition, diagnosis and surgical management of this problem. A case of orthodontic treatment of excessive gingival display associated with altered passive eruption of the maxillary incisors is reviewed to demonstrate appropriate management. With proper diagnosis, soft-tissue periodontal procedures after completion of orthodontic treatment can enhance the patient's final appearance.