Title: Perio Esthetics: Correction of Gummy Smile by Lip Repositioning

Authors: Dr Sandeep Kumar, Dr Sunita R Pal, Dr Manjit Sharma, Dr Sachin Kumar, Dr Jyotsana Gaur, Dr Meena Yadav, Dr Pooja Narain

 DOI: https://dx.doi.org/10.18535/jmscr/v9i1.08

Abstract

Excessive gingival visualization is a cosmetic problem for patients It is a condition in which there is overexposure of the upper gingiva (> 3mm) during the smile. There are many causes of a gummy smile which includes vertical excess of the maxilla, short overactive upper lip, altered passive eruption, anterior dentoalveolar extrusion, or their combinations The correct diagnosis of all the etiological factors is essential for its correct management. Diverse approaches have been used to reestablish the dentogingival relationship for the management of the gummy smile. Surgical lip repositioning is a conventional surgical technique used to manage excess gingival display. It is a largely unknown treatment modality. This limits the lift of the lips to the smile and increases the fullness of the lips. This technique was designed to be shorter, less aggressive, and have fewer postoperative complications than orthognathic surgery. In the current case series, a patient is presented who has been successfully managed with lip repositioning. This article aims to describe the lip repositioning technique to minimize the gummy smile with a simple surgical procedure.

Keywords: Lip repositioning, gummy smile, smile harmony, Vertical Maxillary Excess.

References

1.      Gabrić Pandurić D, Blasković M, Brozović J, Sušić M. Surgical treatment of excessive gingival display using lip repositioning techni­que and laser gingivectomy as an alternative to orthognathic surgery. J Oral Maxillofac Surg. 2014;72:4041–4051.

2.      Tawfik OK, El-Nahass HE, Shipman P, Looney SW, Cutler CW, Brunner M. Lip repositioning for the treatment of excess gingival dis­play: A systematic review. J Esthet Restor Dent. 2017;1–12.

3.      Ribeiro-Júnior NV, Campos TV, Rodrigues JG, Martins TM, Sil­va CO.. Treatment of excessive gingival display using a modified lip repositioning technique. Int J Period Restorative Dent. 2013;33:309– 314.

4.      Bhola M, Fairbairn PJ, Kolhatkar S, Chu SJ, Morris T, de Campos M. LipStaT: the lip stabilization technique—indications and guideli­nes for case selection and classification of excessive gingival display. Int J Period Restor Dent. 2015; 35:549–559.

5.      Abdullah WA, Khalil HS, Alhindi MM, Marzook H. Modifying gummy smile: a minimally invasive approach. J Contemp Dent Pract. 2014 Nov 1;15:821-6.

6.      Jacobs PJ, Jacobs BP. Lip repositioning with reversible trial for the management of excessive gingival display: a case series. Int J Period Restor Dent. 2013;33:169–175.

7.      Humayun N, Kolhatkar S, Souiyas J, Bhola M. Mucosal coronally positioned flap for the management of excessive gingival display in the presence of hypermobility of the upper lip and vertical maxillary excess: a case report. J Periodontol. 2010;81:1858-63.

Corresponding Author

Dr Sandeep Kumar

Consultant& Oral Implantologist, Sharma Dental Clinic Implant & Orthodontic Centre, Westend Plaza, Old Delhi Gurgaon Road, Kapashera Delhi 110037