Objective ·To evaluate the effects of normally positioned flap (NPF) and coronally advanced flap (CAF) techniques on clinical results after epulis excision. Methods ·A total of 55 patients with epulis who visited the Department of Periodontology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from August 2022 to December 2023 were included. The patients were divided into the NPF group and the CAF group. After epulis excision, the surgical area was closed using NPF or CAF technique. The following parameters were recorded: baseline epulis width (EW) and epulis height (EH); papilla width (PW) and papilla height (PH) at 6 months post-surgery; probing depth (PD), attachment loss (AL), and keratinized gingiva width (KGW) at both baseline and 6 months post-surgery. The esthetic outcomes were evaluated using a visual analog scale (VAS) by 2 periodontal specialists. t test was used to compare the differences in periodontal indices between baseline and 6 months post-surgery, as well as between the 2 flap techniques. Results ·At 6 months post-surgery, PD of the CAF group was (1.68±0.79) mm, significantly lower than at baseline (P<0.001), but not significantly different from that in the NPF group (P=0.365); the AL in the CAF group was (1.26±1.18) mm, not significantly different from baseline (P=0.746), but significantly lower than in the NPF group (P<0.001). At 6 months post-surgery, PH of the CAF group was (3.74±0.62) mm, significantly higher than that in the NPF group (P<0.001), and the VAS score of the CAF group was significantly higher than that of the NPF group (P<0.001). Conclusion ·Compared with NPF, CAF could effectively improve post-surgical KGW and reduce AL, which could prevent periodontal soft tissue defects, and improve esthetic outcome after epulis excision.