Aesthetic crown lengthening and lip repositioning surgery: Pre‐ and post‐operative assessment of smile attractiveness

Silva, Cléverson O.; Rezende, Robson I; Mazuquini, Amanda C; Leal, Vinicius C; Amaral, Gislaine S A; Guo, Xiaohan; Tatakis, Dimitris N.

doi:10.1111/jcpe.13461

Cited by 9 publications

(8 citation statements)

References 41 publications

(129 reference statements)

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“…In cases involving HUL alone and HUL with VME, lip repositioning was the technique used in the treatment, as indicated by some authors [ 30 , 43 ]. In cases involving APE with HUL and APE with VME, lip repositioning was used associated with crown lengthening, as indicated in one study to treat APE to achieve better results [ 20 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment

Horn

Elias

Joly

2022

International Journal of Dentistry

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A new technique is proposed in this study to correct the gummy smile (GS) with myotomy, combining lip repositioning with the insertion of polyester threads at the surgical site to act as a physical barrier and control relapse. 11 patients were clinically assessed (30.2 ± 7.43 years old, 90.9% females and 9.10% males). All patients presented gingival display (GD) greater than 4 mm. Hypermobile upper lip (HUL), vertical maxillary excess (VME) + HUL, altered passive eruption (APE) + HUL, and VME + APE were the etiologies identified. Three polyester threads were inserted in each patient one month after the surgery. The GS was measured before, 6 months, and 12 months after the surgery. The results showed a reduction in the mean GD of the patients, 4.42 mm after 6 months ( p value = 0.000) and 4.13 mm after 12 months ( p value = 0.000). The largest relapse was 0.29 mm and was not statistically significant ( p value = 0.07). The Friedman test with pairwise comparisons was used to determine the existence of statistically significant differences in GD between the periods analyzed. The results showed that the proposed technique was successful in treating GS, presenting significant reductions in the GD 12 months after surgery and controlling the relapse.

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Section: Discussionmentioning

confidence: 99%

A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment

Horn

Elias

Joly

2022

International Journal of Dentistry

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“…In the present study, GMP analysis was confined to the maxillary anterior sextant. Although this represents a limitation of the study, it was an intentional choice because the maxillary anterior gingiva represents the most esthetically significant aspect of the tissue and the most relevant for assessment of smile attractiveness, a fact that is well documented 4 . In fact, the distribution pattern of GMP influences smile attractiveness 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Although this represents a limitation of the study, it was an intentional choice because the maxillary anterior gingiva represents the most esthetically significant aspect of the tissue and the most relevant for assessment of smile attractiveness, a fact that is well documented. 4 In fact, the distribution pattern of GMP influences smile attractiveness. 14 Given the reported evidence suggesting that GMP may increase with age in posterior areas 32 and may differ significantly between maxilla and mandible, 38 studies including the rest of the dentition would be helpful in further characterizing GMP, especially when both distribution/extent and intensity are considered.…”

Section: Discussionmentioning

confidence: 99%

“…Smile esthetics play an important role in the overall appearance of an individual and the associated gingival aspects are contributing to smile esthetics 1,2 . The significant contribution of the gingiva to smile esthetics has been documented by patient 3 and independent rater 4 assessments of smile attractiveness improvements in response to surgical interventions aimed to improve gingival appearance. One of the various aspects of the gingiva contributing to smile esthetics is gingival color 5 .…”

Section: Introductionmentioning

confidence: 99%

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Gingival pigmentation: Concurrent assessment of distribution, intensity, and extent in a black population

Longo

Rocha

Santin

et al. 2021

J Esthet Restor Dent

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Objective To evaluate prevalence, distribution, intensity and extent of physiologic gingival melanin pigmentation (GMP) in black individuals. Materials and methods For this cross‐sectional study, GMP was evaluated on digital images by three calibrated examiners, according to de Krom (distribution), DOPI (intensity) and Melanin Index (extent) classifications. Descriptive statistics, Wilcoxon, Mann–Whitney, Kruskal–Wallis, Two‐way ANOVA, chi square, and K‐means cluster analysis were used. Results Seventy participants were recruited. The most prevalent GMP categories were: de Krom category 2 (34.3%), DOPI heavy intensity (57.2%), and Melanin index Degree IV (50%). Significant inter‐group differences were found for age (p < 0.05) but not gender (p > 0.05). Significant correspondence/overlap was observed between classifications (p > 0.05). Three GMP clusters were identified: Cluster 1 (27%; n = 19) had mild asymmetric and interspersed pigmentation; Cluster 2 (46%; n = 32) had heavy pigmentation in one long continuous ribbon, with pink marginal gingiva; and Cluster 3 (27%; n = 19) had heavy pigmentation in one long continuous ribbon, symmetric, and uniform. Conclusions There may be overlap among GMP classification systems. In black individuals, the predominant GMP presentation is one of a broad zone of heavily pigmented attached gingiva, in a continuous strip from central incisors to canines, symmetrical across the midline, and with pink free marginal gingiva. Clinical relevance This is the first study to analyze distribution, intensity, and extent of gingival melanin pigmentation in the same population and to integrate the various classification systems through cluster analysis. The novel findings provide a foundation for patient assessment and counseling and for future studies.

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“…The appearance of a smile plays a fundamental role in judging the attractiveness of a face [ 1 , 2 , 3 ]. Such a linkage has been extensively investigated by many scientific studies aimed at evaluating the perception of smile aesthetics based on the characteristics of the occlusion as well as on the make-up of the examining population [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. A regular and healthy-looking smile is considered an expression of well-being and self-confidence, closely linked to a younger and more attractive appearance [ 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Clear Aligners and Smart Eye Tracking Technology as a New Communication Strategy between Ethical and Legal Issues

Putrino

Marinelli

Raso

et al. 2023

Life

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Smart eye-tracking technology (SEET) that determines visual attention using smartphones can be used to determine the aesthetic perception of different types of clear aligners. Its value as a communication and comprehension tool, in addition to the ethical and legal concerns which it entails, can be assessed. One hundred subjects (50 F, 50 M; age range 15–70) were equally distributed in non-orthodontic (A) and orthodontic (B) groups. A smartphone-based SEET app assessed their knowledge of and opinions on aligners. Subjects evaluated images of smiles not wearing aligners, with/without attachments and with straight/scalloped gingival margins, as a guided calibration step which formed the image control group. Subsequently, the subjects rated the same smiles, this time wearing aligners (experimental images group). Questionnaire data and average values for each group of patients, and images relating to fixation times and overall star scores, were analyzed using these tests: chi-square, t-test, Mann–Whitney U, Spearman’s rho, and Wilcoxon (p < 0.05). One-way ANOVA and related post-hoc tests were also applied. Orthodontic patients were found to be better informed than non-orthodontic patients. Aesthetic perception could be swayed by several factors. Attachments scored lower in aesthetic evaluation. Lips distracted attention from attachments and improved evaluations. Attachment-free aligners were better rated overall. A more thorough understanding as to the opinions, expectations and aesthetic perception of aligners can improve communication with patients. Mobile SEET is remarkably promising, although it does require a careful medicolegal risk–benefit assessments for responsible and professional use.

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Aesthetic crown lengthening and lip repositioning surgery: Pre‐ and post‐operative assessment of smile attractiveness

Cited by 9 publications

References 41 publications

A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment

A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment

Gingival pigmentation: Concurrent assessment of distribution, intensity, and extent in a black population

Clear Aligners and Smart Eye Tracking Technology as a New Communication Strategy between Ethical and Legal Issues

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