Gummy smile treatment using lip repositioning surgery

Abstract

Aim: The present study was performed to evaluate the longevity and efficacy of the lip repositioning surgery by assessment of the gingival display changes that occur after the surgery through clinical & digital methods.Methods: This prospective study included ten female patients who suffered from excessive gingival display due to upper lip hypermobility or short upper lip. Pre-operative measurement of the amount of gingival display were recorded both clinically using an endodontic ruler & digitally using Adobe Photoshop cs6 through a well standardized photographs. The surgery was performed under local anesthesia for all patients by removing part of the labial mucosa (labial vestibule) followed by suturing of the wound by interrupted 0-5 resorbable suture. All patients were followed up at 14 days, 4 months, 8 months and 12 months, postoperative assessment was done by measuring the changes in the gingival display using the same clinical & digital techniques.Results: Post-operative measurements at 14 days follow up, showed obvious reduction in the amount of gum exposure. However complete relapse was observed at 4 months. Conclusion:The longevity of the procedure is questionable with almost complete relapse.

Modified Lip Repositioning Surgery with and without Dual-layered Suturing for Treatment of Gummy Smile Patients

“…16 The use of botulinum toxin injections for treating gummy smile is a good option; however, it does not provide long lasting results. 9,[17][18][19] Furthermore, lip repositioning surgery is associated with a high degree of relapse due to the power of the muscle pull from the levator labii superiors alaque nasi, levator labii superiors, zygomaticus minor, and zygomaticus major. 20 Thus, our study aimed to evaluate the success rate of dual-layered suturing, which There was a statistically significant difference between two curves according to time "days" (log-rank chi-squared= 9.439, df = 1, P = 0.002).…”

“…5,6 One of the major drawbacks of this surgery is the relapse that occurs with almost full regain in the preoperative amount of gum exposure. [7][8][9] That is why several authors proposed lots of modifications for the original technique to overcome this drawback. 5,6,10 Another complication that might happen is the midline shift during suturing due to the removal of the labial frenum, which is why modified lip repositioning surgery was proposed, as it aims at preserving the frenum, thus preventing this complication.…”