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Gummy smile

Xue-Dong Wang, Jie-Ni Zhang, Da-Wei Liu, Fei-Fei Lei, Yan-Heng Zhou
In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars...
July 2016: Korean Journal of Orthodontics
Richard Trushkowsky, David Montalvo Arias, Steven David
Prior to initiating any treatment, it is necessary to visualize the desired outcomes. It then becomes possible to formulate the steps required to achieve this result. Digital Smile Design (DSD) utilizes patient input and information gathered through diagnostic procedures to create an esthetic treatment scheme. In the case presented here, the NYUCD Esthetic Evaluation Form, intraoral and extraoral photographs, mounted diagnostic casts, physical examination, and radiographs were the diagnostic modalities. The gathered information served as a starting point for a wax-up and intraoral mock-up...
2016: International Journal of Esthetic Dentistry
Erdem Ayyildiz, Enes Tan, Hakan Keklik, Zulfikar Demirtag, Ahmet Arif Celebi, Matheus Melo Pithon
OBJECTIVE: The aim of the this study was to evaluate the perception of smile esthetics and alterations in cases of gingival plastic surgery for correction of a gummy smile, by means of alterations in smile photograph among dentistry degree students. MATERIALS AND METHODS: A frontal smile photograph of a 40-year-old woman having normal occlusion was used with diverse compositions of gingival exposure level and crown length of maxillary teeth. The eight photographs were evaluated by 216 dentistry students in five class groups (1(st), 2(nd), 3(rd), 4(th) and 5(th) classes)...
July 2016: European Journal of Dentistry
Hanaa M El Shenawy, Sherine A Nasry, Ahmed A Zaky, Mohamed A A Quriba
BACKGROUND: Gingival hyperpigmentation is a common esthetical concern in patients with gummy smile or excessive gingival display. Laser ablation has been recognized recently as the most effective, pleasant and reliable technique. It has the advantage of easy handling, short treatment time, hemostasis, decontamination, and sterilization effect. AIM: In the present study we wanted to explore the efficacy of a 980 nm wavelength diode laser in gingival depigmentation clinically by using both VAS and digital imaging method as means of assessment...
September 15, 2015: Open Access Macedonian Journal of Medical Sciences
Simone Verardi, Marjan Ghassemian, Andrea Bazzucchi, Antonello F Pavone
One of the most frequent causes of gummy smile is an altered eruption, ie, the gingival margins are located at a more coronal position than normal. These cases can be successfully treated with a periodontal surgical approach. Several techniques may be used, depending on the different anatomic variations. The surgery must be carefully planned so as to avoid discrepancies between the soft tissues and the teeth. Clinical examination and radiographic evaluation will allow clinicians to determine the position of the gingival margin, bone crest, and cemento-enamel junction and thus elicit a correct diagnosis of the subtype of altered eruption...
April 2016: Compendium of Continuing Education in Dentistry
Matheus Bortoluzzi Mantovani, Eduardo Clemente Souza, Fabiano Carlos Marson, Giovani Oliveira Corrêa, Patrícia Saram Progiante, Cléverson Oliveira Silva
Excessive gingival display during smile can result in compromised esthetics. This study aims to report a case of excessive gingival display with multiple etiologies treated by means of modified lip repositioning technique associated with esthetic crown lengthening. A 23-year-old female patient, with 5-mm gingival display during smile caused by altered passive eruption and hypermobility of the upper lip, underwent the modified lip repositioning technique associated with gingivectomy followed by flap elevation and ostectomy/osteoplasty...
January 2016: Journal of Indian Society of Periodontology
Jeff Bynum
When dealing with excessive gingival display it is important for the treating clinician to properly identify the etiology, as potential etiologic factors can vary widely. Treatment decisions in this case involving a patient with high lip dynamics and a "gummy smile" were complicated because treatment recommendations differed for each of the several etiologies involved. The treatment performed, which included orthodontics combined with crown lengthening and in which the final restorations were segmented anterior to posterior to give both the clinician and laboratory improved control, was designed to meet the patient's desired esthetic outcome while addressing the areas of risk established in the preoperative assessment...
February 2016: Compendium of Continuing Education in Dentistry
Antonello F Pavone, Marjan Ghassemian, Simone Verardi
Treating patients with "gummy smiles" and improving smile esthetics has become an integral part of dentistry. It is necessary to conduct an accurate diagnosis of what may be multiple causes that coexist simultaneously. Though all causes may not be resolved following treatment, they should be identified; otherwise it might not be possible to conduct an adequate order of treatment, which could involve multidisciplinary collaboration between various dental specialists, and may lead to unexpected and unacceptable final results...
February 2016: Compendium of Continuing Education in Dentistry
Cuiliu Xie, Yukun Meng
Maxillary protrusion usually requires orthodontic therapy and orthognathic surgery. However, for some exceptional cases, a prosthodontics-centered multidisciplinary approach could serve as an alternative. This case report describes a 53-year-old patient with protrusive and proclined maxillary incisors, compensatory eruption of mandibular incisors, color and morphologic abnormalities of anterior teeth lip incompetence, and gummy smile. Final esthetic improvement was achieved in this patient by means of a multidisciplinary approach involving endodontic and periodontal procedures before prosthodontic treatment...
March 2016: International Journal of Periodontics & Restorative Dentistry
Douglas H Mahn
Excessive gingival display is considered unattractive by many patients. A combination of surgical approaches may be required to correct this problem. Clinical crown lengthening involves recontouring crestal bone levels and moving the gingival margin in an apical direction. Lip repositioning reduces gingival display by limiting upper lip movement when smiling. This article describes a case in which a combination of clinical crown lengthening and lip repositioning was used to correct excessive gingival display when smiling...
January 2016: Compendium of Continuing Education in Dentistry
Mahesh Narayanan, S Laju, Susil M Erali, Sunil M Erali, Al Zainab Fathima, P V Gopinath
Beautification of smiles is becoming an everyday requirement in dental practice. Apart from teeth, gingiva also plays an important role in smile esthetics. Excessive visualization of gingiva is a common complaint among patients seeking esthetic treatment. A wide variety of procedures are available for correction of excessive gum display based on the cause of the condition. Soft tissue diode laser contouring of gingiva is a common procedure that can be undertaken in a routine dental setting with excellent patient satisfaction and minimal post-operative sequale...
2015: Journal of International Oral Health: JIOH
Santhanakrishnan Muthukumar, Shanmuganathan Natarajan, Seenivasan Madhankumar, Jayakrishnakumar Sampathkumar
Esthetic demands have considerably increased over the years in routine clinical practice. A pleasant smile can give supreme confidence to an individuals personality. However, a perfect smile is dictated by a perfect balance of the white (teeth) and pink (gingival) display. This balance can be managed different treatment modalities, which is based on proper diagnosis. This case report demonstrates a successful management of gummy smile with a lip-repositioning procedure in a patient with an incompetent upper lip...
August 2015: Journal of Pharmacy & Bioallied Sciences
Matheus Melo Pithon, Camila Rangel Dos Santos, Nathalia de Lima Santos, Stefanni Olga Aguiar Sales Lima, Raildo da Silva Coqueiro, Rogério Lacerda Dos Santos
OBJECTIVE: To evaluate the extent to which different types of malocclusion influence the development of affective/romantic relationships among young adults of both sexes. MATERIALS AND METHODS: A cross-sectional study was conducted with 360 men and women ranging in age from 18 years to 25 years. Criteria for exclusion from the sample were the following: participants could not be married, visually impaired, or students of a higher education course in the area of health...
July 2016: Angle Orthodontist
Jiao Wei, Tanja Herrler, Hua Xu, Qingfeng Li, Chuanchang Dai
Various techniques to improve gummy smile exist. Depending on the individual etiology, previous approaches have focused on osseous, dental, and soft-tissue aspects. On the basis of the identification of nasal septum dysplasia as etiologic factor of gummy smile, we propose a novel strategy for the improvement in the treatment of excessive gingival exposure. In this prospective controlled study, 121 Asian patients with gummy smile and 150 volunteers were examined and compared with regard to the developmental status of the nasal septal cartilage reflected by the columella upward maximum movability (CUMM) as objective measurement parameter...
October 2015: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Mario Polo
An evaluation and commentary of a recently suggested technique for the correction of gummy smiles is presented. A comparison of long-term stability reported with other surgical techniques, is also performed. From the results reported, use of this technique could offer a treatment option for those affected with excessive gingival display on smiling (gummy smile).
October 2015: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Marwan W Nasr, Samer F Jabbour, Joseph A Sidaoui, Roger N Haber, Elio G Kechichian
BACKGROUND: To date, no standardized minimally invasive approach for the treatment of excessive gingival display exists. OBJECTIVES: This systematic review aims to assess the evidence in the literature regarding the role of botulinum toxin injection in the management of gummy smile. METHODS: All publications through December 2014 and pertaining to the subject were electronically searched in PubMed, Embase, Scopus, and Web of Science, and the bibliographies of retrieved articles were manually screened...
January 2016: Aesthetic Surgery Journal
Aditya Gopinath Rao, Vijay Prasad Koganti, Ashok Kodangala Prabhakar, Sweta Soni
Gummy smile has been an esthetic concern for many patients. This clinical report describes a successful surgical coverage obtained by modified lip repositioning, thus surgically treating the gummy smile. The technique was performed to limit the retraction of elevator muscles (e.g., zygomaticus minor, orbicularis oris, leviator anguli oris and levator labi oris.) The technique is fulfilled by removing two strips of mucosa from maxillary buccal vestibule on both the sides leaving the frenum untouched and creating a partial thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display...
May 2015: Journal of Indian Society of Periodontology
David Montalvo Arias, Richard D Trushkowsky, Luis M Brea, Steven B David
Gummy smile cases are always esthetically demanding cases. This article presents a case treated with an interdisciplinary treatment approach and Digital Smile Approach (DSA) using Keynote (DSA), to predictably achieve an esthetic outcome for a patient with gummy smile. The importance of using questionnaires and checklists to facilitate the gathering of diagnostic data cannot be overemphasized. The acquired data must then be transferred to the design of the final restorations. The use of digital smile design has emerged as a powerful tool in cosmetic dentistry to help both practitioner and patient visualize the final outcome...
July 2015: Dental Clinics of North America
Sameera Babar, John R Calamia, Jerry M Sorrel
This case report presents an interdisciplinary approach to achieve functioning occlusion and an aesthetically pleasing smile. This patient's concerns were spacing between upper front teeth and a gummy smile. The case was evaluated, and treatment was planned using a multidisciplinary approach. The patient rejected the option of orthognathic surgery to correct a skeletal problem. Treatment included orthodontics, osteoplasty, gingivoplasty, and porcelain veneer restorations to achieve the desired aesthetic result...
July 2015: Dental Clinics of North America
Da-Young Kang, Sung-Hwan Choi, Young-Soo Jung, Chung-Ju Hwang
This case report describes the beneficial effects of the interdisciplinary treatment of an adult patient with severe skeletal periodontal problems. A 30-year-old female patient presented with anterior open bite, gummy smile, and facial asymmetry. The patient had chronic generalized severe periodontitis with pathologic maxillary anterior teeth migration and mild intellectual disability. Treatment included 6 months of periodontal treatment, followed by presurgical orthodontic treatment, a Le Fort I osteotomy with anterior segmental osteotomy, a bilateral sagittal split ramus osteotomy, and postsurgical orthodontic treatment...
May 2015: Journal of Craniofacial Surgery
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