New Approach to the Gummy Smile

Ezquerra, F.; Berrazueta, M.; Ruiz-Capillas, A.; Arregui, José Sainz

doi:10.1097/00006534-199909040-00040

Cited by 34 publications

(13 citation statements)

References 3 publications

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“…[8] Hypermobility of the upper lip is caused by hyperfunction of the lip elevator muscles and often results in excessive GD. [9] HUL is considered the primary etiologic factor in excessive GD when the maxillary lip length is within a normal range, and the lower third of the face is proportionate to the remaining thirds.…”

Section: Introductionmentioning

confidence: 99%

Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess

Aly

Hammouda

2016

Dent Res J

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Background:Excessive gingival display (GD) is a frequent finding that can occur because of various intraoral or extraoral etiologies. This work describes the use of a mucosal repositioned flap for the management of a gummy smile associated with vertical maxillary excess (VME) and hypermobility of the upper lip followed by injection of Botox.Materials and Methods:Seven female patients in the age range of 17–25 years presented with a gummy smile. At full smile, the average GD ranged from 6 to 8 mm. A clinical examination revealed hypermobility of the upper lip. A cephalometric analysis pointed to the presence of VME. The mucosal repositioned flap surgery was conducted followed by injection with botulinum toxin type A (Botox) 2 weeks postsurgically.Results:After 4 weeks, results were definitely observed with a decrease from 8 mm gingival exposure to 3 mm, which was considered as normal GD for an adult during smiling.Conclusion:For patients desiring a less invasive alternative to orthognathic surgery, the mucosal repositioned flap is a viable alternative. Moreover, Botox is a useful adjunct to enhance the esthetics and improve patient satisfaction where surgery alone may prove inadequately in moderate VME.

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Section: Introductionmentioning

confidence: 99%

Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess

Aly

Hammouda

2016

Dent Res J

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“…The effective correction of excessive GE cannot be achieved by conservative orthodontic treatment but requires interdisciplinary treatment 3,9,10 and sometimes an invasive surgical procedure. Peck et al 4 reported that orthognathic surgery was the best method to improve the smile.…”

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confidence: 99%

Alteration of Gingival Exposure and Its Aesthetic Effect

Guo¹,

Gong²,

Tian³

et al. 2011

Journal of Craniofacial Surgery

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This study analyzed the computerized variations of gingival exposure (GE) in unattractive smiles and evaluate the aesthetic effect to determine the acceptable range of GE for attractiveness. Images of the frontal posed smile of 50 juvenile women were evaluated in terms of attractiveness by doctors and laypersons separately to select the most unaesthetic one. And the most unaesthetic smile was modified with Photoshop in 2 ways-lowering upper lip and lifting lower lip-and the same evaluators were asked to reevaluate the changed images. We found that the smile with the most significant GE was selected as the most unaesthetic one. The attractiveness ratings were significantly lower in the doctors' group than in the laypersons' group (P < 0.05). The acceptable range of GE in the doctors' group was 0.54 to 2.23 mm, and in the laypersons' group, it was 0.09 to 2.35 mm. Among the many contributors to an attractive smile, GE alteration is the principal one, but not the only, and although 0- to 2.3-mm GE is just an acceptable range; there is an attractive GE degree or point for every individual. Gingival exposure alteration must be balanced against the others in clinical treatment, especially in maxillofacial surgery for the gummy smile.

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“…Treatment involves orthognathic surgery to restore normal inter-jaw relationships and to reduce the gingival display,[18] this involves hospitalization and significant side effects for patients…”

Section: Introductionmentioning

confidence: 99%

Lip repositioning

Gaddale

Desai

Mudda

et al. 2014

J Indian Soc Periodontol

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Excessive gingival display is a frequent finding that can occur because of various intraoral or extraoral etiologies. This report describes the use of surgical lip repositioning technique for the management of a gummy smile associated with vertical maxillary excess and hypermobility of the upper lip. The procedure restricts the muscle pull of the elevator lip muscles by shortening the vestibule, thus reducing the gingival display when smiling. Healing was uneventful and follow-up examinations of 10 months revealed reduced gingival display. For patients desiring a less invasive alternative to orthognathic surgery, lip repositioning is a viable alternative.

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New Approach to the Gummy Smile

Cited by 34 publications

References 3 publications

Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess

Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess

Alteration of Gingival Exposure and Its Aesthetic Effect

Lip repositioning

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