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GUMMY SMILE Reduction - Lebanon
The gummy smile or excess gingival display, is an unaesthetic situation when the gum or gingivae shows alot when smiling. Excessive gingival display, is present at about 7 percent of men and 14 percent of women. It has many causes and appear in many forms.
1. Short and very active maxillary upper lip
2. Altered passive eruption
3. Dental over eruption
4. Excess of vertical maxillary dimension
The treatment in each case is by eliminating the etiology or the cause. We can make a direct gingival reduction, or a lip repositioning or a maxillary height reduction. A combination of etiologies leads to a combination of treatments.
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1. Short and hyperactive maxillary lip
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The maxillary lip should move up in a maximum smile approximately 6 to 8 mm from repose to full smile. However, a person with a hyperactive lip, may have a lip translation 1.5 to 2 times the normal movement distance.The treatment is not dental, as the teeth are in good positions and good proportions. After a good examination and a confirmed diagnosis, if the problem is only from the lip, only a lip repositioning may be considered. We can use diode lasers to perform the lip repositioning. The procedure is simple, it will not change the position of the lip, it will only limit its movement. So when smiling, the lip will not go extremely high. Also another option may be available, it is by using BOTOX (or equivalent ), it may give good results, but the procedure must be repeated every 6 months. |
2. Altered passive eruption
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In the childhood, and during the teeth eruption process, each tooth will extrude from the gum, and than the gum will recede showing the whole crown of the tooth in the oral cavity. Sometimes, and we don't know why, the tooth will extrude from the gum, but the gum will not recede totally, keeping a part of the crown of the tooth covered by the gum. This situation is frequent, it can be diagnosed easy in the clinical examination, as the patient will have short crowns ( square shape teeth instead of rectangular), and while probing the dentist can feel the par of the tooth that it is still covered by the gum. |
| The treatment consist of a crown lengthening surgery, also called gum lifting, which means that a part of the gingivae ( and bone if necessary), will be removed so the the tooth will be exposed completely. | |
| Now , and with the latest high end technologies available at our clinics, we can perform at SOFT Dental Clinics, a very special technique for crown lengthening, using lasers and that without performing a surgery. So no stitches, so bleeding and no pain! The treatment is done in about 30 minutes. |
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Above: In that case, also a whitening has been performed and 2 e.max HT crowns has been placed on the laterals. |
3.Dentoalveolar extrusion
| Dentoalveolar extrusion occurs when the 2 upper central teeth continue to erupt. This condition is generally due to lack of adequate opposing occlusion. In a patient with proper aesthetics, the extension of an imaginary line from upper borders of canine to canine should pass or be very close to the upper borders of the centrals. In addition the lower edge of the centrals must almost touch the lower lips and not overlapping on or hidden by the lower lip. |
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4. Vertical Maxillary Excess
| If the lower face is longer than the mid face, vertical maxillary excess my be the cause of the excess gingival display. The diagnosis is confirmed by cephalometric x-rays. Orthognatic surgery may be required to reposition the maxillae. It is performed at a hospital by a maxillo-facial surgeon. An orthodontic preparation before the surgery is generally needed. Also we will stabilize the occlusion afterward with an orthodontic appliance and treatment. |