Use of modified lip repositioning technique associated with esthetic crown lengthening for treatment of excessive gingival display: A case report of multiple etiologies

Mantovani, Matheus Bortoluzzi; Souza, Eduardo Clemente; Marson, Fabiano Carlos; Corrêa, Giovani Oliveira; Progiante, Patrícia Saram; Silva, Cléverson O.

doi:10.4103/0972-124x.164746

Cited by 28 publications

(23 citation statements)

References 26 publications

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“…In the treatment of a gingival smile, accurate diagnosis is fundamental to select the most appropriate strategy to tackle the problem on an individual basis. When the gingival smile is secondary to altered passive teeth eruption, gingivectomy and/or clinical crown lengthening may be indicated [ 10 , 11 ]. For lip hypermobility, both botulinum toxin and myotomy of lip-elevating muscles are used [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…When the gingival smile is secondary to altered passive teeth eruption, gingivectomy and/or clinical crown lengthening may be indicated [ 10 , 11 ]. For lip hypermobility, both botulinum toxin and myotomy of lip-elevating muscles are used [ 10 , 11 ]. When the cause of the gingival smile is vertical maxillary excess, the treatment may be orthodontic intrusion, orthognathic surgery and even in such cases, if there is a lack of lip support, lip repositioning can be achieved using bone cement combined with clinical crown lengthening [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Labial repositioning using polymethylmethracylate (PMMA)-based cement for esthetic smile rehabilitation—A case report

Arcuri

Costa²,

Ribeiro

et al. 2018

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Labial repositioning using polymethylmethracylate (PMMA)-based cement for esthetic smile rehabilitation—A case report

Arcuri

Costa²,

Ribeiro

et al. 2018

International Journal of Surgery Case Reports

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“…The gingival tissue moves along with the dental crown, and this process is called active eruption. Concomitantly, epithelial adhesion migrates apically from the enamel to a stable coronal position at 1 to 2 mm above CEJ, process called passive eruption (MACHADO, 2014, MANTOVANI et al, 2016. The altered passive eruption (APE) is a clinical condition in which the gingival margin in the adult is located incisal to the cervical convexity of the crown and removed from the cemento-enamel junction of the tooth (ALPISTE-ILLUECA, 2011).…”

Section: Gingivectomy and Gingivoplastymentioning

confidence: 99%

Multidisciplinary Treatment after Orthodontics: Crown Lengthening and Dental Whitening in the Final Aesthetic Resolution of Smile

et al. 2020

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Após a conclusão do tratamento ortodôntico, os pacientes começam a se preocupar com outros fatores estéticos para garantir um sorriso harmonioso, sendo mais exigentes com a aparência. Além de dentes alinhados e harmoniosos, os pacientes estão em busca de um sorriso mais branco, se tornando cada vez mais exigentes com a aparência, cabendo ao dentista atender a essas necessidades. Um outro fator que pode tornar o sorriso antiestético é a presença de dentes curtos, que resulta em exposição excessiva da gengiva e um sorriso com aspecto mais infantil, e que muitas vezes é percebido apenas a finalização do tratamento ortodôntico. O objetivo do presente estudo foi revisar o tratamento estético do sorriso após ortodontia, associando cirurgia periodontal para aumento de coroa clínica e clareamento dental. O sorriso gengival pode ser corrigido integrando várias especialidades odontológicas devido às suas inúmeras causas, podendo ser indicada a realização de procedimentos cirúrgicos, ortodônticos ou restauradores. Quanto ao amarelamento dos dentes, uma das técnicas utilizadas é o clareamento dental, que consiste num procedimento pouco invasivo, indicado na maioria dos casos de manchas extrínsecas. O clareamento pode ser caseiro ou de consultório, mas em ambos os casos, o cirurgião-dentista precisa dominar a técnica. Nesse contexto, cabe ao ortodontista identificar e diagnosticar essas necessidades do paciente e encaminhá-lo para outros especialistas. Em conclusão, para alcançar os resultados esperados pelo paciente são imprescindíveis uma boa anamnese, um correto diagnóstico e o planejamento multidisciplinar do caso. Portanto a inter-relação das especialidades é imprescindível a fim de obter resultados satisfatórios e agradáveis ao paciente. Palavras-chave: Periodontia. Gengivectomia. Estética Dentária. Sorriso. Clareamento Dental. Abstract After the end of orthodontic treatment, patients become more rigorous with their appearance and worry about other aesthetic factors to ensure a harmonious smile. In addition to aligned and harmonious teeth, patients are looking for a whiter smile, becoming more and more rigorous with their appearance, leaving the dentist to meet these needs. Another factor that can impair smile aesthetics is the presence of short teeth, which results in an overexposure of the gum and a smile with a more childlike aspect, and that it is often perceived only at the end of orthodontic treatment. The aim of the present study was to review the aesthetic treatment of the smile after orthodontics, associating periodontal surgery to increase the clinical crown and tooth whitening. Aesthetics is the relationship between several factors. The gummy smile can be corrected by integrating several dental specialties, due to its numerous causes, and surgical, orthodontic or restorative procedures may be indicated. For tooth whitening, one of the techniques most indicated is dental bleaching, which consists of a minimally invasive procedure, indicated in most cases of extrinsic stains. The whitening can be made at home or in office, but in both cases, the dentist needs to master the technique. In this context, it is up to the orthodontist to identify and diagnose these needs of the patient and refer him to other specialists. In conclusion, a good anamnesis, a correct diagnosis and multidisciplinary case planning are essential to achieve the results expected by the patient. Therefore, the interrelationship between specialties is important in order to obtain satisfactory and pleasant results for the patient. Keywords: Periodontics, Gingivectomy, Esthetics, Smiling. Tooth Bleaching.

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“…The normal gingival display is between inferior border of upper lip and gingival margin of anterior central incisors during smile, which accounts for the entire crown of maxillary central incisors and 1 mm of pink attached gingiva. [ 3 ]…”

Section: B Ackgroundmentioning

confidence: 99%

Lip repositioning: A boon in smile enhancement

Sharma¹,

Sharma²,

Garg³

et al. 2017

J Cutan Aesthet Surg

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This clinical report describes the successful use of lip repositioning technique for the reduction of excessive gingival display. The lip repositioning technique was performed with the main objective of reducing gummy smile by limiting the retraction of elevator muscles (e.g., zygomaticus minor, levator anguli, orbicularis oris, and levator labii superioris). This technique includes removing a strip of mucosa from the maxillary buccal vestibule, creating a partial-thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display.

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Use of modified lip repositioning technique associated with esthetic crown lengthening for treatment of excessive gingival display: A case report of multiple etiologies

Cited by 28 publications

References 26 publications

Labial repositioning using polymethylmethracylate (PMMA)-based cement for esthetic smile rehabilitation—A case report

Labial repositioning using polymethylmethracylate (PMMA)-based cement for esthetic smile rehabilitation—A case report

Multidisciplinary Treatment after Orthodontics: Crown Lengthening and Dental Whitening in the Final Aesthetic Resolution of Smile

Lip repositioning: A boon in smile enhancement

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