Lip repositioning with or without myotomy: A randomized clinical trial

Tawfik, Omnia K.; Naiem, Suzy Nabil; Tawfik, L; Yussif, Nermin; Meghil, Mohamed M.; Cutler, Christopher W.; Darhous, Mona; Nahass, Hani El

doi:10.1002/jper.17-0598

Cited by 31 publications

(56 citation statements)

References 24 publications

(48 reference statements)

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“…One of the included studies was an RCT, 11 five were prospective nonrandomized trials, 1,4,13‐15 and the last two were case‐series 16,17 . The studies comprised a total of 114 patients with a mean age of 25.83 years.…”

Section: Resultsmentioning

confidence: 99%

“…In general, the studies performed the surgical procedure conventionally, with the first incision (partial‐thickness) around the mucogingival junction, followed by a second incision 10 mm apically 12 . The soft‐tissue strip between the incisions was removed superficially, thereby preserving the muscle fibers; nonetheless, some studies performed full‐thickness incisions and myotomy 1,4,11,13,15 . The most common suture material used was absorbable (Vicryl 4/0).…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, when the discrepancy involves a nondentoalveolar etiology other approaches are necessary. In these cases, treatment could consist of orthognathic surgery, 9 botulin toxin injections, 10 lip repositioning surgery, 2,11 or the combination of therapies.…”

Section: Introductionmentioning

confidence: 99%

“…Among these treatment possibilities, lip repositioning surgery (LRS) has been described as a conservative surgical procedure for EGD treatment since the 1970s 12 . The procedure presented different modifications over time 11,13,14 ; however, the basis of the technique involves limiting smile muscle contractions. This condition is obtained by removing a band of mucosa from the buccal vestibule depth 3–4 mm above the gingival margin of the maxillary teeth with partial‐thickness elliptical incisions 12…”

Section: Introductionmentioning

confidence: 99%

“…However, its effectiveness is controversial since considerable amounts of relapse have been reported 1,13 . LRS with myotomy was suggested as an option to avoid relapse and maintain stable results, but few studies have examined the long‐term effects 11 . Currently, with the increased number of technique variations and greater patient expectations, it is important to investigate the predictability of LRS.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta‐analysis

Pereira

Cicareli

Idalgo

et al. 2020

J Esthet Restor Dent

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To synthesize the available evidence regarding lip repositioning surgery (LRS) and quantify the short‐ and long‐term reduction in excessive gingival display (EGD) with the procedure. Additionally, evaluate the effect of myotomy on the results. Seven electronic databases were searched up to May 2020 by two independent reviewers. Studies evaluating the exclusive use of LRS to treat EGD were included. After risk of bias assessment, the data were quantitatively evaluated with random‐effects meta‐analysis. The initial database search yielded 368 studies, of which 16 were selected for full‐text review. Finally, eight studies were included. The random effects model exhibited an EGD reduction of 2.87 mm (95% CI: 1.91–3.82) after 3 months of LRS. These results decreased after 6 months (2.71 mm; 95% CI: 1.95–3.47) and 12 months (2.10 mm; 95% CI: 1.48–2.72). Meta‐analysis comparing the performance of myotomy showed greater EGD reduction at 6 months than without myotomy (P < 0.02). LRS is an effective approach for treating EGD, and it has satisfactory results up to 6 months. After this period, the effectiveness appears to progressively decrease over time indicating substantial relapse at 12 months. Myotomy seems a suitable alternative to increase the stability of LRS. Lip repositioning surgery is an effective procedure to improve smile esthetics in the short‐term (up to 6 months). After this period, the efficacy of LRS seems to decrease progressively, and an approximately 25% relapse may be expected after 12 months. Clinicians should combine the procedure with other approaches, such as plastic periodontal surgeries, restorative procedures, or botulin toxin injections for more predictable and stable outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta‐analysis

Pereira

Cicareli

Idalgo

et al. 2020

J Esthet Restor Dent

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Treatment of gummy smile combining crown lengthening, lip repositioning, and the use of polyester threads

Horn

Joly

2022

Clin Adv Periodontics

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Introduction:The case report presents a new possibility of treatment for a gummy smile in a patient with multiple etiologies, such as altered passive eruption and hypermobility upper lip. At first, crown lengthening was not sufficient to achieve the desired aesthetic result, being necessary its combination with lip repositioning. Case Presentation: Crown lengthening surgery (CLS) was performed in a 20year-old woman, with a gingival display of 7.5 mm, having her gingival exposure reduced to 5.5 mm. Because the patient continued unsatisfied after 6 months, a new procedure was adopted. To reduce even more her gingival exposure, lip repositioning technique was performed associated with myotomy and the insertion of polyester threads as a physical barrier to prevent relapse. Conclusion:The result of the gingival display was reduced to 2.5 mm, removing the condition of a gummy smile after the combination of both techniques: crown lengthening, and lip repositioning.

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Non-invasive Approaches for Treatment of Gummy Smile

Pahlevan¹,

Keyhanlou

Abbasi³

et al. 2021

Integrated Procedures in Facial Cosmetic Surgery

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Lip repositioning with or without myotomy: A randomized clinical trial

Abstract: Lip repositioning is an effective method for treating EGD, however, muscle severance provides a more stable result at 12 months when compared to the classical technique. More studies are necessary to fully assess this procedure.

Cited by 31 publications

References 24 publications

Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta‐analysis

Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta‐analysis

Treatment of gummy smile combining crown lengthening, lip repositioning, and the use of polyester threads

Non-invasive Approaches for Treatment of Gummy Smile

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