title: Modifying gummy smile: a minimally invasive approach.
abstract: OBJECTIVE
  Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile.
  
  
  METHODS
  Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit.
  
  
  RESULTS
  At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month.
  
  
  CONCLUSIONS
  This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile.
  
  
  CONCLUSIONS
  A non-invasive procedure to avoid other complicated surgical procedures.
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery Dental College, Mansoura University, Egypt; Dental College King Saud University, Saudi Arabia, e-mail: waa007@gmail.com.
authors.forename: Walid Ahmed
authors.initials: WA
authors.lastname: Abdullah
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Dental College, King Saud University, Saudi Arabia.
authors.forename: Hesham S
authors.initials: HS
authors.lastname: Khalil
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, Dental College, King Saud University, Saudi Arabia.
authors.forename: Maryam M
authors.initials: MM
authors.lastname: Alhindi
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Dental College Mansoura University, Egypt.
authors.forename: Hamdy
authors.initials: H
authors.lastname: Marzook
mesh_terms: D000328:Adult; D004487:Edema / Q000209:etiology; D004955:Esthetics, Dental; D005152:Facial Muscles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology*; D005890:Gingivectomy / Q000379:methods; D006801:Humans; D008046:Lip / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009061:Mouth Mucosa / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012904:Smiling; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alhindi MM; Excessive gingival display. How to cite this article: Abdullah WA; Gummy smile; Khalil HS; Lip repositioning; Marzook H. Modifying Gummy Smile: A Minimally Invasive Approach. J Contemp Dent Pract 2014;15(6):821-826. Source of support: Nil Conflict of interest: None.