Mucosal coronally positioned flap technique for management of excessive gingival display

Bouguezzi, Adel; Boudour, Ouiam Hiba; Sioud, Sameh; Hentati, Hajer; Selmi, Jamil

doi:10.11604/pamj.2020.36.235.22597

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…En otro caso reportado 18 en el 2018 donde aplica el reposicionamiento de labio en una paciente con sonrisa gingival de 8-9 mm e incompetencia labial, logran disminuir la exposición gingival. Un caso expuesto 19 en 2020 reporta una cirugía a un hombre con sonrisa gingival de 7-8 mm e incompetencia labial, después del procedimiento fue reevaluado a los 6 meses y observaron que presentaba había disminuido su exposición gingival a 3mm.…”

Section: Discussionunclassified

Estabilidad de los tejidos blandos posterior al reposicionamiento labial

Montilla,

Ramírez,

Castillo

et al. 2022

ROLA

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Una sonrisa estética se caracteriza por presentar simetría y equilibrio entre las entidades morfológicas faciales y dentales, siendo uno de los aspectos más distintivos de la armonía facial. Cuando un individuo sonríe y muestra una banda de encía mayor a 3 mm, se denomina sonrisa gingival, lo que se considera una condición poco estética, y es una de las razones por la cual la medicina bucal busca atender la insatisfacción de individuos sobre su sonrisa. Existen diversos tratamientos, entre ellos, el reposicionamiento labial, Este tratamiento va a depender de la etiología, es importante destacar que el reposicionamiento labial está indicado cuando la etiología de la sonrisa gingival es un labio maxilar con exceso de movilidad. Siendo una técnica innovadora que consiste en la remoción de una banda de mucosa en el labio superior, apical a la línea mucogingival, para así, reposicionar el labio, disminuyendo la exposición de encía. Esta investigación tuvo como objetivo describir la estabilidad de los tejidos blandos posterior a la cirugía de reposicionamiento labial en pacientes con sonrisa gingival y labios competentes y pacientes con sonrisa gingival e incompetencia labial. Se realizó un estudio descriptivo, de diseño observacional-serie de casos. Se incluyeron 6 pacientes con exposición de tejido gingival mayor a 3 mm, los cuales fueron seleccionados a conveniencia de los investigadores. La exposición preoperatoria en promedio era de 6.1 mm y la reducción promedio obtenida fue de 3.7 mm (58,5%) pasados 5 meses postoperatorio. Los pacientes reportaron satisfacción y conformidad con los resultados, lo que ha llevado a la conclusión de que el reposicionamiento labial es una buena alternativa de tratamiento para disminuir la sonrisa gingival, independientemente si el labio es competente o no, lográndose adicionalmente resultados estéticos en cuanto a la forma del labio superior.

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Section: Discussionunclassified

Estabilidad de los tejidos blandos posterior al reposicionamiento labial

Montilla,

Ramírez,

Castillo

et al. 2022

ROLA

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“…In another study with a 12-month follow-up, the mean value of the rebound was 0.3 mm, which was not statistically significant [ 9 ], demonstrating that the stability can be achieved in longer observations. However, the current available evidence regarding this topic comprises studies with short follow-up [ 20 ], small sample [ 9 ], mixed cases of CL and ACL [ 19 ], lack of correlation assessment [ 27 ], absence of papilla dimensional evaluation [ 28 ], and other factors. The absence of conclusive evidence regarding the level of post-surgery rebound and methods for achieving gingival margin stability after ACL surgery poses challenges for clinicians.…”

Section: Introductionmentioning

confidence: 99%

Dental and periodontal dimensions stability after esthetic clinical crown lengthening surgery: a 12‐month clinical study

Carneiro,

Gomes,

Marinho

et al. 2024

Clin Oral Invest

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Objectives To evaluate the stability of periodontal tissues 3 (T3), 6 (T6), and 12 (T12) months after esthetic crown lengthening (ACL) and the possible correlations between changes in those structures. Materials and methods Twenty individuals were evaluated through clinical assessment, photography, and tomography. Measurements included gingival margin (GM), clinical crown length (CCL), interdental papilla height (PH) and width (PW), gingival thickness (GT), bone thickness (BT), probing depth (PD), distance between alveolar crest and GM, distance between alveolar crest and cementoenamel junction. Nonparametric and correlation statistics were performed (p < 0.05). Results CCL at T0 was 7.42 ± 0.70 mm and increased to 9.48 ± 0.49 mm immediately after ACL, but it decreased to 8.93 ± 0.65 mm at T12. PD decreased 0.60 mm from T0 to T6, and it increased 0.39 mm from T6 to T12. BT decreased 0.20 mm, while GT increased 0.29 mm from T0 to T12. Both PW and PH showed enlargement in T12. A positive moderate correlation was found between CCL/T0 and CCL/T12, GT/T0 and AC-GM/T12, BT/T0 and GT/T12. A few negative moderate correlations were PD/T0 and CCL/T12, PD/T0 and PH/T0, PD/T0 and BT/T12. Conclusions ACL procedure was effective. Although some rebound occurred, that was not clinically important. PD tended to reestablish its original length, partially due to a migration of GM during the healing period. Besides, a thickening of supracrestal soft tissues was observed. Clinical relevance The present study centers on the factors influencing the stability of periodontal tissues after esthetic crown lengthening, underscoring the procedure’s influence on esthetics and biology and the need for careful treatment planning.

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“…The participants were followed up for 1 week to 7 years after lip repositioning surgery. Four studies19,20,25,27 had a follow-up of at least 6 months, three studies 21,23,26 had a follow-up of 12 months, while in one study,18 the follow-up period was 3 years. One study 28 had a follow-up of up to 7 years, with an average of 3.3 years.…”

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confidence: 99%

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

Silva¹,

Abreu²,

Cunha³

et al. 2023

J Oral Res

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Background: The objective of this systematic review and meta-analysis was to answer the questions ‘’Does lip repositioning surgery reduce the amount of gingiva exposed in the smile in individuals with excessive gingival display EGD (excessive gingival display)?’’ and ‘’Is the reduction of the amount of gingiva exposed when smiling obtained with lip repositioning surgery stable over time?’’ to evaluate the effectiveness of lip repositioning surgery for correcting EGD on smiling. Materials and Methods: A systematic structured search was carried out in five databases without data restriction. Studies reporting the degree of reduction in gingival ex-posure after lip repositioning surgery were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate Results: One hundred sixty-four references were retrieved and eleven studies met the eligibility criteria. Meta-analysis demonstrated that lip repositioning surgery results in a significant reduction in the amount of exposed gingival tissue (mean difference = -3.03; confidence interval = -3.55; -2.52). In addition, the results remained stable in the evaluated follow-up periods (1, 3, 6 and 12 months). Included studies had a low risk of bias. Conclusions: Lip repositioning surgery is effective for the treatment of EGD on smiling and exhibits stable results in the evaluated periods. The study was registered (CRD42020184866) in the international prospective register of systematic reviews (PROSPERO). Keywords: Lip; Gingiva; Smiling; Lip repositioning; Excessive gingival display; Esthetic periodontal surgery

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Mucosal coronally positioned flap technique for management of excessive gingival display

Cited by 4 publications

References 17 publications

Estabilidad de los tejidos blandos posterior al reposicionamiento labial

Estabilidad de los tejidos blandos posterior al reposicionamiento labial

Dental and periodontal dimensions stability after esthetic clinical crown lengthening surgery: a 12‐month clinical study

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

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