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

Abstract

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.

Lip Repositioning Surgery: A Simple Smile and Life Transformation Procedure

“…There are countless cases [ 17 – 19 ] when the combination of gingivectomy with lip repositioning is done, especially in cases where we have more than 4 mm of gingival exposure [ 9 ], as in our case. Therefore, performing a gingivectomy following lip repositioning surgery helps eliminate any remaining irregularities or inconsistencies.…”

Korrektur eines Gummy Smile mit Hilfe einer Mini-Implantat-Verankerung – Direkte versus indirekte Verankerung

“…Das Gummy Smile wird vor allem bei stärkerer Ausprägung zumeist als ästhetisch störend empfunden 3 . Zur Korrektur eines Gummy Smile kommen je nach Indikation eine chirurgische Impaktion des Oberkiefers 4 , eine Intrusion des oberen Frontzähne 1 , eine chirurgische Kronenverlängerung mittels Gingivektomie 5 6 und gelegentlich auch ein orofaziales Training zur Stärkung des Lippenschlusses oder Botox-Injektionen in Frage 7 8 9 . Der Umfang einer Gingivoplastik ist von sowohl von der Taschensondierungstiefe als auch von der Relation zwischen dem Limbus alveoloaris und der Schmelz-Zement-Grenze abhängig.…”

Reshaping Smiles: A Successful Clinical Case with Botulinum Toxin for Gummy Smile Reduction

“…(BTX) (7), orthodontics (8), orthognathic surgeries (9), lip repositioning (10), polyester threads (11), or even a combination of the treatments mentioned above.…”