The treatment of gummy smile: integrative review of literature

Moura, Dayanne Monielle Duarte; Lima, Emanuelle Louyde Ferreira de; Lins, Ruthinéia Diógenes Alves Uchôa; Souza, Rodrigo Othávio de Assunção e; Martins, Ana Rafaela Luz de Aquino; Gurgel, Bruno César de Vasconcelos

doi:10.4067/s0719-01072017000100026

Cited by 15 publications

(27 citation statements)

References 11 publications

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“…The majority of the sample (91.4%) was between 13 and 30 years old, which is the most frequent age group for mucogingival surgeries (Moura et al, 2017; Zucchelli & De Sanctis, 2000). Half of the sample was female, all were systemically healthy and 90% were nonsmokers (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Anatomic factors influencing dimensions of soft tissue graft from the hard palate. A clinical study

Said

Khalid²,

Farook

2020

Clinical & Exp Dental Res

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Objectives The aim of the present study was to measure the thickness of the palatal mucosa in a Jordanian (Middle Eastern) population as well as identify possible factors that may influence the thickness of palatal mucosa. Material and Methods Sixty period on tally healthy subjects (29 males and 31 females) were selected. Fifteen measurement points were defined on the palate. The mucosal thickness in the hard palate was determined by “bone sounding” with a Hu‐Friedy® round periodontal probe. Results The overall mean thickness of the palatal masticatory mucosa was 3.23 ± 0.47 mm.The mean thickness increased from the gingival margin to a more apical position irrespective of the tooth measured or side of the mouth in the following sequence: canine, second molar, first premolar, second premolar and lastly, the first molar. No significant difference between gender, smoking status, gingival phenotype andsides of the mouth with the thickness of palatal masticatory mucosa was determined. A significant difference between palatal shape and palatal gingival thickness was found. Conclusions The most appropriate site for graft harvesting is the canine‐premolar area 8‐13 mm from the mid‐palatal aspect of each respective tooth in a Jordanian population. Except for the palatal shape, the side of the mouth, smoking, gender or gingival phenotype does not affect the graft harvest. Clinical Relevance Scientific Rationale for Study Knowledge on the thickness of the masticatory mucosa is crucialin making decisions for surgical treatment modality and may affect surgical outcome. We measured the thickness of the palatal mucosa in a Jordanian population and identified possible influencing factors. Principal Findings The thickness varied according to the teeth and the canine to premolar region was found to be the appropriate donor site. Practical Implications This information on safe zone for graft harvest can guide the periodontist to make appropriate incisions and choose the appropriate location to obtain a graft of adequate thickness and dimensions.

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Section: Discussionmentioning

confidence: 99%

Anatomic factors influencing dimensions of soft tissue graft from the hard palate. A clinical study

Said

Khalid²,

Farook

2020

Clinical & Exp Dental Res

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“…Gingivectomy has also been performed in cases of inflammatory or drug‐induced or, in rare cases, congenital gingival enlargement 11,12 . Moreover, osteoplasty has also been applied successfully to treat GS; 13 the current study applied these two surgical procedures plus modification of lip repositioning procedure to treat GS to the patients’ great satisfaction.…”

Section: Discussionmentioning

confidence: 97%

Surgical Procedures Reducing Excessive Gingival Display in Gummy Smile Patients With Various Etiologic Backgrounds

Zardawi

Gul

Fatih

et al. 2020

Clin Adv Periodontics

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Introduction Gummy smile (GS) is an esthetic issue which causes a person to show a larger than average amount of gum tissue when smiling. Lip repositioning procedure is a surgical treatment option performed by removing a partial thickness strip from the maxillary buccal vestibular mucosa and suturing back the lip mucosa to the mucogingival line. High rate of relapse has been recorded with this procedure. In this study, different treatment options were applied according to the etiology and clinical background of each individual case in an attempt to overcome relapse. Furthermore, modification of the conventional lip repositioning procedure and the clinical outcome of this technique will be demonstrated in this report. Case Series Among the four selected patients who requested correction of their GS, the amounts of gingival display (GD) measured using digital Vernier were from 5 to 7 mm. Clinical examination revealed variation in the length of the clinical crowns, and vestibular depth and width of keratinized gingiva. Since the causes of their GS were different, different surgical modalities were applied to address GS in this case series. The procedures were gingivectomy, osteoplasty, and modification of lip repositioning procedure performed by removing a partial thickness ribbon of the keratinized attached gingiva and then suturing the labial alveolar mucosa to the attached gingiva at a level more coronal to its previous position. Conclusion One‐year follow‐up showed that all these surgical procedures reduced excessive GD by 2 mm without relapse and the patients were satisfied with the esthetic outcome.

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“…lengthening surgery, orthodontics, orthognathic surgery, injecting botulism toxins or myotomies. 19 The most common method employed or extensively reported in the literature for its management is crown lengthening surgery (gingival recontouring with or without osseous surgery). 19 It establishes the desired gingival margin position while simultaneously avoiding violation of the biologic width.…”

Section: Discussionmentioning

confidence: 99%

Aesthetic rehabilitation in a patient with skeletal mandibular deficiency and open bite: journey from splinted metalloceramic prosthesis to all-ceramic crowns

2020

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Abstract This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for localised periodontal disease and poor aesthetics. At multiple sites the ceramic had chipped off and the prosthesis colour did not match with the adjacent healthy teeth. A multidisciplinary approach of endodontics, periodontics and prosthodontics was employed for this case. The treatment plan consisted of removing the faulty prosthesis, endodontic retreatment of inadequately root-treated teeth and endodontics in the other coronally prepared abutment teeth. Crown lengthening surgery was performed for the correction of periodontal pockets and high smile line and maintenance of an adequate biological width. After periodontal healing, all-ceramic individual crowns were placed on the maxillary anterior teeth along with a three-unit all-ceramic bridge for the replacement of the left upper maxillary first premolar. Continuous...

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The treatment of gummy smile: integrative review of literature

Cited by 15 publications

References 11 publications

Anatomic factors influencing dimensions of soft tissue graft from the hard palate. A clinical study

Anatomic factors influencing dimensions of soft tissue graft from the hard palate. A clinical study

Surgical Procedures Reducing Excessive Gingival Display in Gummy Smile Patients With Various Etiologic Backgrounds

Aesthetic rehabilitation in a patient with skeletal mandibular deficiency and open bite: journey from splinted metalloceramic prosthesis to all-ceramic crowns

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