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Gummy smile

Xiang Gao, Tao Wang, Jinlin Song
In this case report, we present the orthodontic and surgical management of an 18-year-old girl who had a severe craniofacial deformity, including maxillary prognathism, vertical maxillary excess (gummy smile), mandibular retrognathism, receding chin, and facial asymmetry caused by unilateral temporomandibular joint ankylosis. For correction of the facial asymmetry, the patient's right mandibular ramus and body were lengthened via distraction osteogenesis after 5 months of preoperative orthodontic therapy. Subsequently, extraction of 4 first premolars, bimaxillary anterior segmental osteotomy, and genioplasty were simultaneously performed in the second-stage operation to correct the skeletal deformities in the sagittal and vertical planes...
April 2017: American Journal of Orthodontics and Dentofacial Orthopedics
Cheol-Ho Paik, Hong-Sik Park, Hyo-Won Ahn
A 20-year-old woman visited the office complaining of a gummy smile and lip protrusion. She was diagnosed with vertical maxillary excess without open bite and skeletal Class II hyperdivergent pattern. She refused the surgical-orthodontic treatment option, although she wanted to correct the gummy smile and retruded chin. Differential intrusion of anterior and posterior teeth in both arches was necessary to maximize the skeletal treatment effects. In the maxilla, one palatal temporary anchorage device (TAD), an archwire with an accentuated curve of Spee, and a transpalatal arch were applied...
March 20, 2017: Angle Orthodontist
Lobna Abdel Aly, Nelly Ibrahim Hammouda
BACKGROUND: Excessive gingival display (GD) is a frequent finding that can occur because of various intraoral or extraoral etiologies. This work describes the use of a mucosal repositioned flap for the management of a gummy smile associated with vertical maxillary excess (VME) and hypermobility of the upper lip followed by injection of Botox. MATERIALS AND METHODS: Seven female patients in the age range of 17-25 years presented with a gummy smile. At full smile, the average GD ranged from 6 to 8 mm...
November 2016: Dental Research Journal
Ravleen Nagi, Deepa Jatti Patil, Shashikant Sahu, Supreet Jain, Giridhar S Naidu
Botulinum toxin is a polypeptide protoxin synthesized by Clostridium botulinum that results in localized reduction of muscle activity by inhibiting acetylcholine release at the neuromuscular junction. In 2004, the US Food and Drug Administration approved its application in the treatment of various medical conditions, such as facial wrinkles, strabismus, cervical dystonia, blepharospasm, and hyperhidrosis. Later, its application extended to improving dental esthetics and gummy smile. It was found to be a safe and effective alternative to medical therapy to treat various head and neck disorders that have a neurologic component...
April 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Nayansi Jha, Jae Jun Ryu, Rizwan Wahab, Abdulaziz A Al-Khedhairy, Eun Ha Choi, Nagendra Kumar Kaushik
Gingival hyperpigmentation and the condition known as gummy smile are very common dental cosmetic problems. Gingival hyperpigmentation arises due to the excess presence of melanin in certain regions of the gums. In the case of gummy smile, more than the required amount of gingival tissue is exposed upon smiling. An aesthetically pleasing smile should expose only a negligible amount of gingival tissue. Gummy smile and gingival hyperpigmentation can have detrimental effects on the aesthetic quality of a smile, and thereby a wide variety of treatment options must be taken into consideration depending patient outcome objectives...
March 21, 2017: Oncotarget
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...
December 0: 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
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