An Integrated modified lip repositioning using bioresorbable collagen membrane: A long-lasting auxiliary treatment approach for gummy smile

Abstract

Excessive gingival display is one of the major causes of patient embarrassment. An imbalance in the gingiva–tooth ratio results in the dominance of gingival appearance often referred to as “gummy smile.” A normal gingival display between the inferior border of the upper lip and the gingival margin of the central incisors during a normal smile is 1–2 mm. In contrast, an excessive gingivae-to-lip distance of 4 mm or more is classified as an unattractive. The objective of lip repositioning surgery is surgical correction of unesthetic gummy smile by limiting the retraction of the elevator smile muscles resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display during smiling. This article presents a case of a gummy smile in which esthetic correction was achieved through periodontal plastic surgical procedure wherein 10–12 mm of partial-thickness flap was dissected apical to mucogingival junction sparing the midline maxillary labial frenum and placement of bioresorbable collagen membrane on excised area followed by approximation of flaps. This case with score 3 smile line was treated by lip repositioning technique with successful clinical outcome and enormous patient satisfaction. This technique holds importance as perioesthetics has become an integral part of periodontal treatment plan with the periodontist playing akey role to combat the patient's embarrassment.