Objective: A papilla preservation crown-lengthening procedure (PPCL) was proposed for treatment of the maxillary anterior teeth (canine to canine) and compared to two traditional techniques. Method and Materials: Thirty patients were assigned to three treatment groups: PPCL, the apically positioned flap with buccal approach (APF-B), and the apically positioned flap with buccal and palatal approach (APF-BP). Several clinical parameters were recorded at baseline and 6 months after surgery. Results: Although no statistically significant differences were reported in many of the clinical parameters examined, APF-B and APF-BP showed a significantly higher interproximal clinical attachment loss when compared to PPCL. In the PPCL group, there was a significant increase in esthetic appraisal by the patients. Conclusion: Crown lengthening using a papilla-preservation flap approach and osseous recontouring is a viable alternative approach and could be useful in esthetic regions. Keywords: anterior esthetic, apically positioned flap, osseous resection, papilla preservation, surgical crownlengthening