A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment

Area of Science:

• Oral and Maxillofacial Surgery
• Cosmetic Surgery
• Plastic Surgery

Background:

• Gummy smile (GS), characterized by excessive gingival display (GD) over 4mm, affects patient aesthetics.
• Common etiologies include hypermobile upper lip (HUL), vertical maxillary excess (VME), and altered passive eruption (APE).
• Existing treatments may have limitations in controlling relapse.

Purpose of the Study:

• To evaluate a novel surgical technique for gummy smile correction.
• To assess the efficacy of combining lip repositioning with polyester thread insertion for controlling relapse.
• To measure the reduction in gingival display (GD) and long-term stability of the treatment.

Main Methods:

• A cohort of 11 patients with gummy smile (GD > 4mm) underwent a new surgical technique.
• The procedure involved myotomy, lip repositioning, and insertion of three polyester threads as a physical barrier.
• Gingival display was measured pre-operatively, and at 6 and 12 months post-surgery.

Main Results:

• A significant reduction in mean gingival display was observed: 4.42mm at 6 months (p=0.000) and 4.13mm at 12 months (p=0.000).
• The maximum observed relapse was 0.29mm, which was not statistically significant (p=0.07).
• Statistical analysis confirmed significant reductions in GD and effective relapse control.

Conclusions:

• The proposed technique combining myotomy, lip repositioning, and polyester threads is effective for gummy smile correction.
• The method demonstrates significant and stable reduction in gingival display over 12 months.
• Polyester threads serve as a successful physical barrier, controlling relapse in gummy smile treatment.