Management of class 2 gingival display by lip repositioning surgery- A case report

Ruchi Banthia; Antush  Mittal; Sucheta Endaw; Beauty Rani

doi:10.21276/ujds.2025.v11.i2.20

Dr. Ruchi Banthia Professor and Head
Dr. Antush Mittal Professor
Dr. Sucheta Endaw BDS
Dr. Beauty Rani BDS

DOI: https://doi.org/10.21276/ujds.2025.v11.i2.20

Keywords: Gummy smile, Excessive gingival display, Lip repositioning

Abstract

Background-Success of any surgery in the anterior teeth region is guided by patient related outcomes and surgical skill of the operator. Patient related aesthetics is governed by many factors involving soft tissues and teeth. Gummy smile or excessive gingival display may be caused due to various reasons and causes a serious aesthetic concern. Case report-This case report presents a 26-year-old female patient with gummy smile due to lip hypermobility treated with lip repositioning surgery. A Class 2 gingival display of about 5mm extending from maxillary right second premolar to left second premolar was noted. The patient was recalled after every 6 months for follow-up. The gingival display was approximately 2mm at 6 months. The patient was highly pleased and satisfied with the aesthetic outcome. Conclusion- The lip repositioning surgery seems to be a predictable option for correction of gummy smile. The success rate of the procedure depends on the case criteria.

References

1. Sapkota B, Srivastava S, Koju S, Chettiar RS. Evaluation of Smile Line in Natural and Forced Smile Position: An Institution-based Study. Orthod J Nepal 2017;7(1): 27-32.
2. Bhola M, Fairbairn PJ, Kolhatkar S, Chu SJ, Morris T, de Campos M. LipStaT: The Lip Stabilization Technique- Indications and Guidelines for Case Selection and Classification of Excessive Gingival Display. Int J Periodontics Restor Dent 2015;35(4):549-59.
3. Peck S, Peck L, Kataja M. Some vertical lineaments of lip position. Am J Orthod Dentofacial Orthop 1992;101(6):519-24.
4. Sethna GD, Parmar HM, Gaikwad RP, Nabazza SS. Objective smile analysis and its relationship with the lip length in an Indian population–An institution based study. Int Org Sci Res-J Dent Med Sci 2019;18(2): 67-75.
5. Silva CO, Ribeiro-Júnior NV, Campos TVS, Rodrigues JG and Tatakis DN. Excessive gingival display: treatment by a modified lip repositioning technique. J Clin Periodontol 2012:40(3):260–5.
6. Ganesh B, Burnice NKC, Mahendra J, Vijayalakshmi R, K AK. Laser-assisted lip repositioning with smile elevator muscle containment and crown lengthening for gummy smile: A Case Report. Clin Adv Periodontics 2019;9(3):135-41.
7. Wachtel H, Schenk G, Böhm S, Weng D, Zuhr O, Hürzeler MB. Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects: a controlled clinical study. J Clin Periodontol 2003;30:496–504.
8. Sarfi D, Bouzoubaa S M, Yahya IBI. Lip repositioning technique. A simple surgical procedure to improve the harmony and symmetry of the smile: A case report. Adv Oral Maxillofac Surg 2022;6:100260.
9. Tjan AH, Miller GD, The JG. Some esthetic factors in a smile. J Prosthet Dent 1984;51(1):24-8.
10. Liebart MF, Fouque DC, Santini A et al. Smile line and periodontium visibility. Perio 2000 2004;1:17-25.
11. Kostianovsky AS, Rubinstein AM. The "Unpleasant" smile. Aesthetic Plast Surg 1976 Dec;1(1):161-6.
12. Rosenblatt A, Simon Z. Lip repositioning for reduction of excessive gingival display: a clinical report. Int J Periodontics Restorative Dent. 2006;26(5):433-7.
13. ‌ Tatakis DN. Lip Repositioning Techniques and Modifications. Dent Clin N Am 2022; 66(3): 373-84.
14. Gupta KK, Srivastava A, Singhal R, Srivastava S. An innovative cosmetic technique called lip repositioning. J Indian Soc Periodontol 2010;14(4):266-9.
15. Tawfik OK, El-Nahass HE, Shipman P, Looney SW, Cutler CW, Brunner M. Lip repositioning for the treatment of excess gingival display: A systematic review. J Esthet Restor Dent 2018;30(2):101-12.