Elimination of gingival smile

A gingival smile is one of the main causes of aesthetic concerns. An imbalance in the gum-to-teeth ratio leads to gum dominance. There is a need to improve the balance and harmony between all three components: lips, teeth and gums.

The normal exposure of the gum between the lower border of the upper lip and the gingival edge of the central incisors during a normal smile is 1-2 mm. In contrast, the distance from the gum to the lips of 4 mm or more is classified as an unattractive and unaesthetic appearance.

The procedure was first described in the plastic surgery literature in 1973 by Rubinstein A.M. The purpose of the lip repositioning procedure is the surgical correction of an unaesthetic gingival smile, with limited functioning of the tension of the muscles responsible for smiling (zygomaticus minor, levator anguli, orbicularis oris and levator labii superioris), which leads to a decrease in the oral vestibule and limited muscle tension.

Normally, when a person smiles, the entire crown of the central incisor and 1 mm of pink gum are exposed. A larger gum exposure (2-3 mm) may be cosmetically acceptable as long as the gum is not excessively visible. The lip repositioning technique that we use in comparison with other treatment methods not only meets the requirements of patients, but also gives good healing results.

In addition, this method has an advantage over others because it is a simple, effective, quick, minimally invasive, cost-effective surgical method with good results.

The limitations for this technique are considered to be severe skeletal deformities and severe vertical hypertrophy of the upper jaw with excessive exposure of the gums, which must be corrected by orthognathic surgery.