Severe Gummy Smile Research Articles

An Innovative Procedure for Lip Lengthening in a Patient with a Short Upper Lip and High-Angle Skeletal Class II Pattern: A Case Report

Skeletal class II malocclusion in adult patients with severe gummy smile is challenging for orthodontist and often requires surgical intervention. The difficulty increases when patients refuse orthognathic surgery, and orthodontists have limited treatment alternatives. This report describes the case of a patient with severe dento-skeletal class II malocclusion with excessive gingival display while smiling. The patient was treated with temporary anchorage devices, and an innovative method of lip repositioning was devised to correct the irregularity.

Horseshoe Le Fort I osteotomy for gummy smile and facial asymmetry: Two cases

Introduction: In cases with gummy smile or asymmetry of the maxilla, superior repositioning of the maxilla is required. If superior repositioning by a Le Fort I osteotomy alone is difficult, a horseshoe Le Fort I osteotomy can be used. Presentation of cases: Case 1: A 24-year-old Japanese woman patient presented with a gummy smile and an open bite. After we performed a horseshoe Le Fort I osteotomy, the maxillary segment was repositioned superiorly 3.0 mm at upper tooth number 1 (U1) and 5.0 mm at upper tooth number 6 (U6). Case 2: A 21-year-old Japanese man presented with severe facial asymmetry. After we performed a unilateral modified horseshoe Le Fort I osteotomy, the maxillary segment was superiorly repositioned 6.0 mm at the right U6. Discussion: This procedure eliminated the risk of intraoperative bleeding because it was unnecessary to remove bones around the descending palatine artery, and it was possible to maintain the chamber size of the nasal cavities. Conclusion: The horseshoe Le Fort I osteotomy is a reliable technique for cases with severe gummy smile or asymmetry of the maxilla.

Comment on “Botulinum toxin type-A as an alternative treatment for gummy smile: a case report”

Currently, the search for esthetic excellence has become the main objective in the facial treatment. The gummy smile is one of the complaints from the patients, since this situation may influence their self-esteem and social relationship. The development of new techniques, such as the application of botulinum toxin, may be a conservative therapeutic option in the treatment of gummy smile. The purpose of this letter is to comment some points about a case report publicated in Dermatology Online Journal, of a patient with dentogingival discrepancy and severe gummy smile, who was treated with application of botulinum toxin in order to optimize the harmony of the smile.

Improvement of Severe Gummy Smile by Botulinum Toxin Application and Gingivoplasty

Currently, the search for aesthetic excellence has become the main objective in the dental treatment. The gummy smile is one of the complaints from the patients, since this situation may influence their self-esteem and social relationship. The development of new techniques, such as the application of botulinum toxin, may be a therapeutic option more conservative, in the treatment of gummy smile. The purpose of this article is to present a case of a patient with dentogingival discrepancy and severe gummy smile, who was treated with gingivoplasty and application of botulinum toxin in order to optimise the harmony of the smile.

Incidence of gummy smile in Han adolescents

Objective To investigate the incidence and characteristics of gummy smile in Han adolescents. Methods A self-imposed questionnaire of gummy smile was used. Gummy condition of 1156 Han people in Chongqing Medical University were measured when they smiled and displayed 8 maxillary anterior teeth. Smiles were divided into four categories (no gummy smile under 2 mm, gummy smile: mild 2-3 mm, moderate 3-4 mm, severe >4 mm). To investigate incidence of gummy smile, the differences between women and man groups and urban and rural groups were compared. Five examiners evaluated esthetics of mild, moderate and severe gummy smile. Results Incidence of gummy smile in Han adolescents was 17.91% (207). Incidence of mild, moderate and severe gummy smile were 10.03% (116), 6.22% (72) and 1.64% (19), respectively. Incidence of gummy smile in women 19.41% (172) was higher than men 12.96% (35) (P<0.05). There was no statistical difference between urban and rural groups. Conclusions Incidence of gummy smile is high in Han adolescents with a greater prevelance in females as compared to males. Severe gummy smile affects the esthetics severely and needs for treatment in order to improve self-image. Key words: Gummy smile; Han adolescents; Incidence

Severe gummy smile with class II malocclusion treated with LeFort I osteotomy combined with horseshoe osteotomy and intraoral vertical ramus osteotomy.

In this article, we report the successful surgical treatment of a patient, 34 years of age, who had a severe gummy smile and a class II malocclusion. The patient had an 11-mm gingival exposure during full smile and a convex profile. A LeFort I osteotomy combined with a horseshoe osteotomy was used for the superior repositioning of the maxilla;then, an intraoral vertical ramus osteotomy (IVRO) and genioplasty were performed for mandibular advancement. The maxilla was acceptably impacted 8mm at the first incisor and 5mm at the first molar. Both the occlusion and facial appearance were significantly improved by this surgical-orthodontic treatment. Our results suggest that the combination of a horseshoe osteotomy with a LeFort I osteotomy is a useful technique for reliable superior repositioning of the maxilla.

The correction of severe gummy smile using orthognathic surgery: Case report

The purpose of this study is to report onoperative treatment for patients with severe gummy smile. In this case, the patient was a 17-year-old female who had a chief complaint of too much exposed gingiva when smiling. The patient had a class I molar key with bimaxillary protrusion and severe gummy smile. Because achievement of complete improvement of gummy smile was thought to be diffi cult, bimaxillary orthognathic surgery was planned. LeFort I osteotomy and bilateral sagittal split osteotomy (BSSRO) performedunder general anesthesiaresulted in alleviation of bimaxillary protrusion and severe gummy smile. A satisfactory esthetic result was achieved. Therefore, for a satisfactory result, two-jaw surgery using LeFort I osteotomy and BSSRO may be considered as a solution for treatment of severe gummy smile, which is thought to be diffi cult to solve using only an orthodontic method.

Adult Class II Division 1 patient with severe gummy smile treated with temporary anchorage devices

A 23-year-old Mongolian woman came for a consultation with chief complaints of protrusive lips and a gummy smile. The clinical examination showed a convex profile, a protrusive maxilla, excessively proclined and extruded maxillary incisors, and a Class II Division 1 malocclusion. Temporary anchorage devices (TADs) in the posterior dental region were used as anchorage for the retraction and intrusion of her maxillary anterior teeth. Those appliances, combined with a compensatory curved maxillary archwire, eliminated the severe gummy smile and the protrusive profile, and corrected the molar relationship from Class II to Class I. With no extra temporary anchorage devices in the anterior region for intrusion, the treatment was workable and simple. The patient received a satisfactory occlusion and an attractive smile.

Severe high angle Class II Division 1 malocclusion with vertical maxillary excess and gummy smile: A case report

Severe Class II Division 1 malocclusion with vertical maxillary excess and gummy smiles can be treated in several ways. Early orthodontic treatment with vertical control may decrease the malocclusion as well as improve the appearance. In severe cases, orthognathic surgery might be the optimal solution. The following case report describes a patient with a severe gummy smile, where the final esthetic improvement was achieved by using a periodontal procedure after orthodontic treatment. (Am J Orthod Dentofacial Orthop 1999;116:317-20)