Excessive gingival display is a frequent finding that can occur because of various intraoral or extraoral etiologies. Nov 19, 2012 lip repositioning surgery jacob horwitz. Therefore, lip repositioning is recommended as an alternative treatment for egd. Some patients have bruising, swelling, and discomfort, though these side effects tend to be minimal. Moreover, gingival display was lip repositioning technique for the.
Lip repositioning surgery is a relatively simple procedure, which has few postop complications and may be a permanent treatment for excessive gingival display. Eliminating a gummy smile with surgical lip repositioning. Gingival or gummy smile is the problem for patients who want to be treated with fixed appliance but also who dont want to wear appliances. An alternative to invasive surgery a 4 year follow. Lip repositioning surgery to address excessive gingival display induced by different etiologies has received major attention recently. Pdf treatment of excessive gingival display using a modified lip gables perfect smile lip reposition surgery in miami by. Proper case selection is important for using this procedure. The objectives of this article are to present a case in which the surgical technique of. Surgical lip repositioning technique simon,rosenblatt and dorfman.
Smile designing by surgical lip repositioning with gingival. The results obtained with lip repositioning for the treatment of gummy smile are substantial and it is a simple and effective procedure, well accepted by patients. Simon is a periodontist who completed his specialty training. This technique was designed to be shorter, less aggressive and to have fewer postoperative complications compared to orthognathic surgery.
The aim of this study was to evaluate and compare conventional and modified lip repositioning surgical techniques used for management of gummy smile involving hyperactive lip elevator muscles. Lip repositioning surgery for the reduction of excessive gingival display. Simply put, lip repositioning is the lowering of the upper lip. Case report lip repositioning with crown lengthening.
Surgical lip repositioning procedure to correct excessive. Surgical treatment of excessive gingival display using lip. A case report is presented to show the preparatory and surgical steps used to treat a 25yearold patient with egd using lip repositioning technique as an. While this is an elective treatment, no reported cases have yet offered patients the ability to. The lip repositioning procedure is a simple surgical technique designed to restrict high movement of the upper lip. A case report is presented to show the preparatory and surgical steps used to treat a 25yearold patient with egd using lip repositioning technique as an alternative to invasive surgery with satisfactory results that has been stable for 4 years.
Pdf lip repositioning with reversible trial for the. New periodontal surgical techniques have shifted our focus towards the lip position in relation to the dentofacial complex when smiling. Surgical lip repositioning procedure to improve facial profile in a. Anatomic crown lengthening is performed 6 months after the. The objective of lip repositioning is to limit the retraction of elevator smile muscles. Excessive gingival display, gingival depigmentation, gummy smile, lip repositioning, periodontal plastic surgery. Postoperative symptoms included mild pain and swelling with feeling of tension on the upper lip while smiling. This case report summarizes the use of surgical lip repositioning technique for the management of a gummy smile. Surgical lip repositioning is an effective treatment in reducing excessive gingival display and improving facial profile. Lip positioning surgery for gummy smilethin upper lip.
Simon is a periodontist who completed his specialty training and obtained his master of science degree at the university of toronto. This procedure is minimally invasive technique to orthognathic surgery for. A gummy smile or a high smile line may lead to a poor smile which can have impact on patients appearance and confidence. Sep 09, 2015 presented modified lip repositioning surgery is a predictable technique for the treatment of excessive gingival display due to hyperactive upper lip, resulting in high level of patient satisfaction. However, this requires hospitalization and entails significant discomfort. He is a diplomate of the american academy of periodontology as well as a fellow of the. When excessive gum tissue displays between the edge of the lower lip and the bottom of the teeth, the gum tissue can detract from the natural beauty of the teeth and smile.
Surgical technique lip repositioning after local anesthesia septocaine 4% with 1. Lip repositioning surgery for the reduction of excessive. Lip repositioning is a surgical way to correct gummy smile by limiting the retraction of the elevator smile muscles e. Lip repositioning surgery takes about 3045 minutes to perform.
Lip repositioning is a brief surgical procedure that restricts the top lip and positions the lip to reduce the amount of exposed gum tissue. Contraindication for lip repositioning surgery includes inadequate width of attached gingiva because of the difficulties of performing a flap reflection, stabilization, and suturing. Patients will see a bright, confident smile as soon as they leave dr. Lip repositioning has been under the radar because of its unique approach to correct gs.
A prospective study was conducted between april 2016 and may 2017. I am interested in scheduling lip repositioning surgery with a doctor in florida hopefully to fix how high my upper lip curls when i smile. May 31, 20 in patients with jaw deformities, orthognathic surgery can be performed. Lip repositioning is a conservative surgical technique used to treat. This new lip repositioning surgery is an innovative intraoral technique which corrects the excessive retraction of the upper lip producing a more harmonious and aesthetically pleasing appearance when. Satisfactory surgical healing with minimal operative sequelae was observed and significant reduction in gingival display was observed after 1 week, 4 weeks and 4 months followup. As any swelling dissipates, the results will continue to improve. Lip repositioning surgery is a largely unknown and underutilized treatment modality for excessive gingival display. The objective of this case series was to examine the outcome of lip repositioning surgery for correction of excessive gingival display. Lip repositioning surgery is a relatively simple procedure, which has few postop complications and maybe a permanent treatment for excessive gingival display. This case report demonstrates the successful management of excessive gingival display with a lip repositioning procedure. Removing gum tissue with laser therapy can only correct so much of this defect.
Treatment of excessive gingival display by means of a modified lip repositioning technique results in high level of patient satisfaction and predictable outcomes that are stable in the short term. This procedure also is successful in increasing lip volume and for the correction of an asymmetrical smile. Gallardo will perform his lip repositioning procedure using a local anesthetic or iv sedation. The worst part of undergoing the procedure was the discomfort or the inability to move the lip during the early healing 69%. Several techniques and variations have been reported, including myotomy or repositioning of the levator labii superioris muscle, le fort impaction, maxillary gingivectomies, botulinum toxin injections, and lip stabilization. This case report demonstrates the successful management of excessive gingival display with a liprepositioning procedure. Lip repositioning for reduction of excessive gingival display. This report describes the use of surgical lip repositioning technique for the management of a gummy smile associated with vertical maxillary. A case report is presented to show the preparatory and surgical steps used to treat a 25yearold patient with egd using lip repositioning technique as an alternative to invasive surgery with. Nowadays, and depending on the case, the contemporary dentist can offer minimally invasive treatments which allow us to modify the shape of the hard and soft tissues. Feb 02, 2018 lip repositioning was first described in the literature of plastic surgery in 1973 by rubinstein and kostianovsky, which was advocated again by litton and fournier for correction of excessive gingival display in the presence of short upper lip. Lip repositioning surgery for correction of excessive. Lip repositioning results in shallow vestibule restricting the muscle pull thereby limiting the gingival display during smiling.
The benefits of the technique can be seen immediately. This case series shows the esthetically enhanced smiles in three patients who underwent lip repositioning surgery. The procedure involves removing a strip of partial thickness mucosa from maxillary vestibule, then suturing it back to the lip mucosa at the level of mucogingival junction. The procedure limits the muscle pull of the elevator muscles of the lip by shortening the vestibule, thus reducing the. The amount of epithelium to be excised was determined by doubling the amount of gingival display. This is accomplished by removing a strip of mucosa from the maxillary buccal vestibule, then suturing the lip mucosa to the mucogingival line. A comparison between modified and conventional surgical.
During this procedure, he will remove a strip of tissue from the inner portion of the top lip. Modified lip repositioning with esthetic crown lengthening. An integrated modified lip repositioning using bioresorbable. A successful management of excessive gingival display with lip repositioning procedure has shown excellent results. With the help of a sharp probe, bleeding points were induced at the mucogingival junction, which guided the first incision to be carried out.
The procedure restricts the muscle pull of the elevator lip muscles thereby reducing the gingival display while smiling. For patients with egd and a short or hypermobile upper lip, surgical lip repositioning lrp is a viable treatment alternative to other more invasive procedures such as orthognathic surgery. It favors clinicians and patients due to its less invasive approach and minimal postoperative complications. Lip repositioning, aesthetic crown lengthening, and gingival. Lip repositioning is a conservative surgical technique used to treat excess gingival display. Lp also improves esthetics for patients with vme reducing hypermobile lips and gummy smile without the need for orthognathic surgery. This limits lip elevation on smiling and increases lip fullness. Lip repositioning is suggested as an additional treatment modality for patients with lip hypermobility exposing undesired gingivae in a smile. Lip repositioning, an alternative treatment of gummy smile. For an excessive gingival display according to vme classification degree ii, iii orthognathic surgery is preferred.
Lip repositioning technique with smile elevator muscle. Lip repositioning was first described in the literature of plastic surgery in 1973 by rubinstein and kostianovsky, which was advocated again by litton and fournier for correction of excessive gingival display in the presence of short upper lip. The objective of lip repositioning surgery is surgical correction of unesthetic gummy smile by limiting the retraction of the elevator smile muscles zygomaticus minor, levator anguli, orbicularis oris and levator labii superioris resulting in a narrow vestibule and restricted muscle pull thereby reducing gingival display during smiling. In the present case, as there was an adequate width of attached gingiva and adequate crown length, crown lengthening was not appropriate.
The patient decides to pursue these treatment options. In patients with jaw deformities, orthognathic surgery can be performed. Presented modified lip repositioning surgery is a predictable technique for the treatment of excessive gingival display due to hyperactive upper lip, resulting in high level of patient satisfaction. Lip repositioning surgery for gummy smile correction. The procedure was first introduced in 1973 and resulted in reduced morbidity compared with orthognathic surgery while resulting in predictable improvement. The combination of surgical lip repositioning with periodontal plastic surgery yields highly effective results in. Lip repositioning is a simple surgical procedure to treat gummy smile. This case series shows the esthetically enhanced smiles in three patients who underwent lip. It involves precise resection of maxillary mucosal tissues with reattachment of the lip in a more coronal position. For patients with egd and short or hypermobile lip, surgical lip repositioning is a viable treatment alternative to orthognathic surgery.
Eliminating a gummy smile with surgical lip repositioning clinical science simon, rosenblatt, dorfman dr. Lip repositioning surgery san francisco ca san francisco. J cosmetic dentistry,spring 2007 lip repositioning technique the procedure restricts the muscle pull of the elevator lip muscles by shortening the vestibule, thus reducing the gingival display when smiling. While any surgical procedure can increase your risk of infection, bleeding, and pain, lip repositioning surgery tends to be very safe. Lip repositioning an innovative cosmetic technique youtube. Could anyone advise whether this would be the best rout to go. The combination of surgical lip repositioning with periodontal plastic surgery yields highly effective results in the treatment of gummy smiles.
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