The Lip Repositioning Surgery: A Review of the Technique's Evolution

Abstract

The lip repositioning technique (LRT) is considered a safe and predictable gummy smile (GS) treatment. However, since Rubinstein and Kostianovsky introduced it in 1973, it has undergone several modifications. This article aims to review and provide a historical compilation of LRT evolution to help clinicians understand each technique's description and the rationale for its modifications to treat GS.An electronic search was performed in Medline, Scopus, and Cochrane Library up to May 2021 including the terms “lip repositioning,” “lip repositioning technique,” or “lip repositioning surgery” and studies evaluating or discussing the original LRT's modifications in detail. The search had no language or time restrictions. Additionally, a hand-searching of references of all included articles was performed.Modifications described in the literature include muscle severance, subperiosteal dissection of the gingiva, frenectomies, and the use of adjuvant products. They aim to minimize relapse, morbidity, and improve stability. Discomfort, scar formation, and pain were the most frequent complications reported. The choice to use a modification should be analyzed and customized to the individual patient's needs.

Creating smile aesthetics by using crown lengthening and upper lip repositioning surgical operations together in a gingival smile case: a case report

“…9 Combining the lip repositioning technique with other approaches such as periodontal plastic surgeries, restorative procedures, or Botox injections has been suggested to achieve more predictable and consistent results. 10 Modifications of surgical lip repositioning have been reported in the medical literature. Several articles advocate smile muscle disconnection to prevent the smile muscle from returning to its original position and to minimize flap tension during suturation.…”

“…In modified lip repositioning surgeries, swelling, ecchymosis, edema in the upper lip and perioral region, minor bleeding, and mucocele formation were reported. 10…”

Reposicionamiento labial como tratamiento de la sonrisa gingival: Revisión narrativa de la literatura

“…El concepto de una sonrisa depende básicamente de la entidad de tres componentes anatómicos: encía, dientes y labios. (Gonzales-Medina et al, 2021;Mahardawi et al, 2019). La visualización gingival excesiva (EGV), también llamada sonrisa gingival, se define como una condición no patológica en donde podemos observar una exposición gingival de más de 4 mm que se toman desde el extremo inferior del labio superior y el margen gingival de los dientes (Jasser, 2019).…”