Modifying gummy smile: a minimally invasive approach

Area of Science:

• Oral and Maxillofacial Surgery
• Aesthetic Dentistry
• Minimally Invasive Procedures

Background:

• Excessive gingival display, or gummy smile, affects facial aesthetics and patient confidence.
• Management options range from non-surgical to surgical interventions, with patient preference leaning towards minimally invasive techniques.
• The choice of procedure depends on the etiology of the gummy smile.

Purpose of the Study:

• To describe and evaluate a modified, minimally invasive lip repositioning technique for managing excessive gingival display.
• To assess the efficacy and patient satisfaction associated with this lip repositioning procedure.

Main Methods:

• A modified lip repositioning technique was performed on twelve patients (10 females, 2 males) with significant gingival display (≥4 mm) under local anesthesia.
• Surgical dissection and repositioning of the levator labii superioris and depressor septi muscles were performed, with sutures maintaining the lower lip position for 10 days.
• Patients were followed for 12 months, with measurements of gingival display and assessments of surgeon and patient satisfaction recorded at multiple intervals.

Main Results:

• Postoperative gingival display was reduced to a mean of 2.6 mm at 1 month and 3 mm at 3 months, with sustained results up to 12 months.
• High patient satisfaction was reported, with 10 out of 12 patients satisfied at 1 month, and 8 out of 12 satisfied at 3, 6, and 12 months.
• Minor temporary complications included upper lip tension and mild pain; complete relapse occurred in one patient.

Conclusions:

• The modified lip repositioning technique is an acceptable and minimally invasive option for managing gummy smiles.
• This procedure offers a less complex surgical alternative for patients seeking aesthetic improvement of excessive gingival display.
• The technique demonstrates good long-term results and high patient satisfaction, making it a valuable addition to the treatment armamentarium.