Lip repositioning with or without myotomy: a systematic review

Excessive gingival display is an esthetic issue that is commonly managed by different procedures. Lip repositioning is a modality to address concerns of affected patients. The aim of this review was to investigate the scientific evidence on outcomes and long-term stability of lip repositioning surgery with or without myotomy. The electronic search was conducted in three databases: MEDLINE, Embase, and the Cochrane Library up to October 2019. No publication status, language, or time restrictions were applied. The electronic search was complemented by a manual search of the reference lists. Three hundred thirty-eight studies were screened by title, and 16 articles remained for data extraction. The included studies assessed the lip repositioning procedure in 144 patients aged between 15-59 years (134 females and 10 males). Based on the available data, lip repositioning with myotomy/muscle containment can be a successful treatment for minor discrepancies in gingival display in selected cases. However, further well-organized controlled clinical trials are recommended to derive a conclusion about the long-term stability compared with other alternatives.