Orthognathic Surgery for Management of Gummy Smile

Excessive gingival show is mainly caused by hypermobility of the upper lip, altered passive eruption, gingival hyperplasia, and bony maxillary vertical excess. Orthognathic surgery is the optimal treatment option for patients with moderate and severe vertical maxillary excess. Surrounding anatomic structures and soft tissue changes such as alternation in the nasal morphology confine the amount of impaction. Therefore, Le Fort 1 may be performed in conjunction with horseshoe osteotomy or partial turbinectomy. The possible necessity of further mandibular orthognathic surgeries and chin repositioning has to be considered. No common major complication and long-term relapse have been reported for maxillary impaction.