Lip repositioning as a gingival smile treatment: Narrative literature review
DOI:
https://doi.org/10.33448/rsd-v13i6.45950Keywords:
LipStat; Excessive gingival display; Lip repositioning; Gummy smile; Gingivectomy; Crown lengthening.Abstract
The gingival smile is a non-pathological condition where there is excessive exposure of the gingiva greater than 4 mm that impairs the aesthetics of two patients. It is a multifactorial condition, therefore making a correct diagnosis is essential to determine a correct treatment plan. Lip repositioning surgery is a technique that we see being implemented for the treatment of gingival sores that consists of removing a piece of mucosa from the vestibule, thus achieving a piece between the union of the mucogenic and apical lining of the upper lip muscles, curing this shape or vestibule and reducing excessive gingival exposure. The objective of this article is to understand the advances and considerations that must be taken into consideration in the implementation of the lip repositioning technique as a treatment for gum disease. Methodology: a literature review was carried out over the last 5 years by means of electronic search in the databases Science direct, Scielo, Pubmed and Google Scholar. Results: were included 22 scientific articles in which we observe the etiology, advantages and how the technique evolved over time. Conclusion: It is a widely used technique because it is minimally invasive, presents fewer postoperative complications, faster recovery and can be used in combination with other surgical or non-surgical techniques; More long-term studies are necessary, because there is also a high risk of recurrence.
References
Abdullah, W. A., Khalil, H. S., Alhindi, M. M., & Marzook, H. (2014). Modifying Gummy Smile: A Minimally Invasive Approach. The Journal of Contemporary Dental Practice, 15(6), 821-826. https://doi.org/10.5005/jp-journals-10024-1625
Alammar, A. M., & Heshmeh, O. A. (2018). Lip repositioning with a myotomy of the elevator muscles for the management of a gummy smile. Dental and Medical Problems, 55(3), Article 3. https://doi.org/10.17219/dmp/92317
Al-Bahadli, M., & Al-sudani, S. (2023). Extravagant gingival display: A review of the literature. MDJ, 18(2), 268-274.
Almeida, N. N. de, Oliveira, A. V. L. de, Carvalho, T. de A., & Borges, D. C. (2022). Tratamento cirúrgico periodontal para correção do sorriso gengival: Revisão integrativa da literatura. Research, Society and Development, 11(14), Article 14. https://doi.org/10.33448/rsd-v11i14.36101
Aly, L. A., & Hammouda, N. I. (2016). Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess. Dental Research Journal, 13(6), 478-483. https://doi.org/10.4103/1735-3327.197039
Ardakani, M. T., Moscowchi, A., Valian, N. K., & Zakerzadeh, E. (2021). Lip repositioning with or without myotomy: A systematic review. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 47(1), 3-14. https://doi.org/10.5125/jkaoms.2021.47.1.3
Arroyo-Carbajal, N. A. (2019). Reposicionamiento labial para el tratamiento de la sonrisa gingival. Revisión de la literatura. Revista Científica Odontológica, 7(2), Article 2. https://doi.org/10.21142/2523-2754-0702-2019-97-107
Batista Jr., E. L., Moreira, C. C., Batista, F. C., de Oliveira, R. R., & Pereira, K. K. Y. (2012). Altered passive eruption diagnosis and treatment: A cone beam computed tomography-based reappraisal of the condition. Journal of Clinical Periodontology, 39(11), 1089-1096. https://doi.org/10.1111/j.1600-051X.2012.01940.x
Bhola, M., Fairbairn, P., Kolhatkar, S., Chu, S., Morris, T., & Campos, M. (2015). LipStaT: The Lip Stabilization Technique- Indications and Guidelines for Case Selection and Classification of Excessive Gingival Display. The International journal of periodontics & restorative dentistry, 35, 549-559. https://doi.org/10.11607/prd.2059
Cairo, F., Graziani, F., Franchi, L., Defraia, E., & Pini Prato, G. P. (2012). Periodontal Plastic Surgery to Improve Aesthetics in Patients with Altered Passive Eruption/Gummy Smile: A Case Series Study. International Journal of Dentistry, 2012, e837658. https://doi.org/10.1155/2012/837658
Catalano, M. (2021). Aesthetic surgical treatment in anterior maxilla: Comparison between Lip repositioning versus Crown lengthening. Literature Review. [Universidade Fernando Pessoa]. ProQuest Central. https://bdigital.ufp.pt/bitstream/10284/10295/1/PPG_35078.pdf
Chacon, G. (2020). Modified lip-repositioning technique for the treatment of gummy smile. International Journal of Esthetic Dentistry, 15(4), 474-488.
Coslet, J. G., Vanarsdall, R., & Weisgold, A. (1977). Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. The Alpha Omegan, 70(3), 24-28.
Delgado, J. G. (2020). Sorriso Gengival: Diagnóstico Diferencial e Opções Terapêuticas - Revisão Narrativa. [Universidade Fernando Pessoa]. ProQuest. https://www.proquest.com/openview/9c8ba02269f83706dd8eea676911b3d7/1?cbl=2026366&diss=y&pq-origsite=gscholar
Dos Santos, E. (2020). Alternativas de tratamento do sorriso gengival com hiperfunção do lábio superior: Revisão de literatura. [Universidad de Fernando Pessoa]. ProQuest Central. https://repositorio.bahiana.edu.br:8443/jspui/handle/bahiana/5419
Durigon, M., Alessi, B. P., Neves, M., & Trentin, M. S. (2018). Perception of dentists, dental students, and patients on dentogingival aesthetics. Revista de Odontologia Da UNESP, 47, 92-97. https://doi.org/10.1590/1807-2577.08917
Ellenbogen, R., & Swara, N. (1984). The Improvement of the Gummy Smile Using the Implant Spacer Technique. Annals of Plastic Surgery, 12(1), 16. https://doi.org/10.1097/00000637- 198401000-00004.
França, C. C. G. (2020). Técnica cirúrgica de reposicionamento labial para correção do sorriso gengival – revisão da bibliografia [MasterThesis, Universidad de Fernando Pessoa]. ProQuest. https://bdigital.ufp.pt/handle/10284/9357
Freitas de Andrade, P., Meza-Mauricio, J., Kern, R., & Faveri, M. (2021). Labial Repositioning Using Print Manufactured Polymethylmethacrylate- (PMMA-) Based Cement for Gummy Smile. Case Reports in Dentistry, 2021, e7607522. https://doi.org/10.1155/2021/7607522
García Catalán, V., Nieto Sánchez, I., Musa Herranz, S., Rodríguez Lozano, G., Macias Gago, A., & Aneiros Fernández, L. (2018). Revisión bibliográfica: La sonrisa gingival y la eficacia de su tratamiento con las técnicas de reposicionamiento labial e inyección de toxina botulínica. Ortodoncia española: Boletín de la Sociedad Española de Ortodoncia, 56(1 (Enero-Abril)), 17-27.
Gonzales-Medina, K., Mendoza-Geng, A., & Vergara-Buenaventura, A. (2021). The Lip Repositioning Surgery: A Review of the Technique’s Evolution. European Journal of General Dentistry, 10(3), 176-182. https://doi.org/10.1055/s-0041-1736380
Guan, Y.-X., Xin, L., Tian, P.-F., Kyung, H.-M., Kwon, T.-G., Bing, L., Wu, X.-P., Guan, Y.-X., Xin, L., Tian, P.-F., Kyung, H.-M., Kwon, T.-G., Bing, L., & Wu, X.-P. (2019). Efecto del Grosor del Tejido Blando en la Morfología del Labio en el Tratamiento de Ortodoncia. International Journal of Morphology, 37(4), 1245-1251. https://doi.org/10.4067/S0717-95022019000401245
Humayun, N., Kolhatkar, S., Souiyas, J., & Bhola, M. (2010). Mucosal coronally positioned flap for the management of excessive gingival display in the presence of hypermobility of the upper lip and vertical maxillary excess: A case report. Journal of Periodontology, 81(12), 1858-1863. https://doi.org/10.1902/jop.2010.100292
Ishida, L. H., Ishida, L. C., Ishida, J., Grynglas, J., Alonso, N., & Ferreira, M. C. (2010). Myotomy of the Levator Labii Superioris Muscle and Lip Repositioning: A Combined Approach for the Correction of Gummy Smile. Plastic and Reconstructive Surgery, 126(3), 1014. https://doi.org/10.1097/PRS.0b013e3181e3b6d4
Jacobs, P. J., & Jacobs, B. P. (2013). Lip repositioning with reversible trial for the management of excessive gingival display: a case series. International Journal of Periodontics & Restorative Dentistry, 33(2). https://doi.org/ 10.11607/prd.1483.
Jasser, R. N. A. (2019). Proper Diagnosis and Management of Dental Smile Esthetics from Periodontal Perspective: Literature Review. Saudi Journal of Oral and Dental Research. DOI:10.21276/sjodr.2019.4.6.8.
Kostianovsky, A. S., & Rubinstein, A. M. (1976). The “Unpleasant” smile. Aesthetic Plastic Surgery, 1(1), 161-166. https://doi.org/10.1007/BF01570248
Litton, C., & Fournier, P. (1979). Simple Surgical Correction of the Gummy Smile. Plastic and Reconstructive Surgery, 63(3), 372. https://doi.org/10.1097/00006534-197903000-00014
Mahardawi, B., Chaisamut, T., & Wongsirichat, N. (2019). Gummy Smile: A Review of Etiology, Manifestations, and Treatment. Siriraj Medical Journal, 71(2), Article 2. https://doi.org/10.33192/Smj.2019.26
Mantovani, M. B., Souza, E. C., Marson, F. C., Corrêa, G. O., Progiante, P. S., & Silva, C. O. (2016). Use of modified lip repositioning technique associated with esthetic crown lengthening for treatment of excessive gingival display: A case report of multiple etiologies. Journal of Indian Society of Periodontology, 20(1), 82-87. https://doi.org/10.4103/0972-124X.164746
Martinez, V., & Romero, A. (2021). Reposicionamiento labial: Reporte de caso. Research, Society and Development, 10, e502101120218. https://doi.org/10.33448/rsd-v10i11.20218
Mele, M., Felice, P., Sharma, P., Mazzotti, C., Bellone, P., & Zucchelli, G. (2018). Esthetic treatment of altered passive eruption. Periodontology 2000, 77(1), 65-83. https://doi.org/10.1111/prd.12206
Miskinyar, S. a. C. (1983). A New Method for Correcting a Gummy Smile. Plastic and Reconstructive Surgery, 72(3), 397. https://doi.org/10.1097/00006534-198309000-00027
Orozco Varo, A. (2014). Estudio odontométrico de longitud y anchura de las coronas clínicas del sector antero-superior en una muestra de población adulta. [Tesis doctoral. Universidad de Sevilla]. https://idus.us.es/handle/11441/24107
Ribeiro, F. V., Hirata, D. Y., Reis, A. F., Santos, V. R., Miranda, T. S., Faveri, M., & Duarte, P. M. (2014). Open-Flap Versus Flapless Esthetic Crown Lengthening: 12-Month Clinical Outcomes of a Randomized Controlled Clinical Trial. Journal of Periodontology, 85(4), 536-544. https://doi.org/10.1902/jop.2013.130145
Rosenblatt, A. y Simon, Z. (2006). Reposicionamiento de labios para reducir la exposición gingival excesiva: un informe clínico. Revista Internacional de Periodoncia y Odontología Restauradora. 26 (5), 433-7. PMID: 17073353.
Silva, J. C. e, Abreu, L. G., Cunha, F. A., Freire, B. L., & Lima, R. P. E. (2023). Effectiveness of lip repositioning in the treatment of excessive gingival display: Systematic review and meta-analysis. Journal of Oral Research, 12, 35-47.
Tagliafierro, N. (2021). Reposicionamento Labial Convencional Versus Modificado na Abordagem Combinada do Tratamento do Sorriso Gengival: Revisão Narrativa. [Universidad de Fernando Pessoa]. ProQuest Central. https://www.proquest.com/openview/b98d36e5c2b7896c8a19f67d5fe9fe82/1?cbl=2026366&diss=y&pq-origsite=gscholar
Tawfik, O. K., Naiem, S. N., Tawfik, L. K., Yussif, N., Meghil, M. M., Cutler, C. W., Darhous, M., & El-Nahass, H. E. (2018). Lip repositioning with or without myotomy: A randomized clinical trial. Journal of Periodontology, 89(7), 815-823. https://doi.org/10.1002/JPER.17-0598
Telletxea Iraola, M., López-Malla Matute, J., & Alía García, E. (2020). Las tres caras de la sonrisa gingival. Revisión bibliográfica. Científica dental: Revista científica de formación continuada, 17(2), 59-66.
Torres, É. M., Valladares-Neto, J., Bernades, K. de O., Naldi, L. F., Torres, H. M., Carvalho, A. L., & Estrela, C. (2020). Facial profile changes due to bone cement graft to manage the hyperactive muscles of the gingival smile. Dental Press Journal of Orthodontics, 25(2), 44-51. https://doi.org/10.1590/2177-6709.25.2.044-051.oar
Vergara-Buenaventura, A., & Mendoza, G. (2020). Predictability in Lip Repositioning with Botulinum Toxin for Gummy Smile Treatment: A 3-Year Follow-up Case Series. The International journal of periodontics & restorative dentistry, 40, 703-709. https://doi.org/10.11607/prd.4645
Vital Ribeiro-Júnior, N., de Souza Campos, T. V., Guilherme Rodrigues, J., Azevedo Martins, T. M., & Silva, C. O. (2013). Treatment of Excessive Gingival Display Using a Modified Lip Repositioning Technique. International Journal of Periodontics & Restorative Dentistry, 33(3), 308-315. https://doi.org/10.11607/prd.1325
Younespour, S., Yaghobee, S., Aslroosta, H., Moslemi, N., Pourheydar, E., & Ghafary, E. S. (2021). Effectiveness of Different Modalities of Lip Repositioning Surgery for Management of Patients Complaining of Excessive Gingival Display: A Systematic Review and Meta-Analysis. BioMed Research International, 2021, 1-19. https://doi.org/10.1155/2021/9476013
Zardawi, F. M., Gul, S. S., Fatih, M. T., & Hama, B. J. (2020). Surgical Procedures Reducing Excessive Gingival Display in Gummy Smile Patients With Various Etiologic Backgrounds. Clinical Advances in Periodontics, 10(3), 130-134. https://doi.org/10.1002/cap.10089
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nicole Adriana Juela Corte; Valentina Martinez Peraza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.