Lip repositioning: An alternative cosmetic treatment for gummy smile

Abstract

Excessive gingival display, commonly referred to as ‘gummy smile’ is a major hurdle in overall personality of an individual. Gummy smile, secondary to altered passive eruption and tooth mal-positioning, can be predictably treated with Surgery and orthodontic therapy. In patients with jaw deformities, orthognathic surgery can be performed. However, this requires hospitalization and entails significant discomfort. Lip repositioning is a simple surgical procedure to treat ‘gummy smile’. The procedure restricts the muscle pull of the elevator lip muscles thereby reducing the gingival display while smiling. This procedure is safe and predictable with minimal risk or side effects. This case report describes the successful treatment of excessive gingival display using surgical lip repositioning procedure which can be used as an alternative treatment modality for treatment of excessive gingival display.

Dudağın Yeniden Konumlandırılması Operasyonu Dişeti Gülümsemesi Tedavisinde Gerçekten Etkili Mi?

“…In the follow-up appointment 3 months after the operation, these patients reported that this sensation of tension went away. In the literature, several studies have been conducted regarding the extent to which LR operations provide reduction in the amount of gums that are visible during smiling (15,26,33,34). Tawfik et al, in their systematic study that aimed to determine the amount of reduction in the amount of gingival visibility during smiling provided by LR operation, reported a mean reduction amount of 3.4 mm for a 6month period (27).…”

“…As the treatment of GS varies based on its etiology, determining the etiology that caused it before treatment is important for the success of the operation. (9) Orthognathic surgery (10), botulinum toxin application on the muscles that regulate smiling (11), myotomy (12,13), gingivectomy (14) and lip repositioning (15)(16)(17) are methods that are used in GS treatment. A study on patients with complaints of GS reported that hypermobile upper lip syndrome was the most dominant etiological factor that led to GS by itself in approximately 45.3% of the patients and alongside passive eruption in approximately 34% of patients (18).…”

“…Nowadays, it is a method that is frequently used by itself or in combination with other treatment methods for treating GS caused by hypermobile upper lip (22)(23)(24). This method is also used as an alternative to orthognathic surgery in the case of GS caused by vertical maxillary excess (15). It is believed that lip repositioning is a more applicable method in comparison to time-consuming and expensive surgical procedures that lead to various complications such as orthognathic surgery (22,25).…”

“…On the other hand, many studies also reported that the amount of gingival visibility after lip repositioning operation increased in time, and there were cases of relapse (8,13,15,28). The purpose of this study is to investigate how much reduction the MLR technique, which is considered to be a conservative method in treatment of gummy smile, achieves in the amount of gingival visibility and whether or not relapse occurs in the 3rd-6th months after operation.…”

Lip repositioning: A boon in smile enhancement

“…Adequate local infiltration was administered in the buccal vestibule between the first maxillary premolars. The incision outline was marked with an indelible pencil on the dried tissue using mucogingival junction and base of the vestibule as reference lines connected at mesial line angles of the right and left maxillary premolars to create an elliptical outline[ 6 ] as shown in Figure 2 . A partial thickness incision was made between these two lines, and epithelial band approximately 10–12 mm wide was excised leaving underlying connective tissue exposed [Figures 3 – 5 ].…”