Case Study Of Gummy Smile

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SMILE CORRECTION BY GINGIVAL DEPIGMENTATION AND LIP REPOSITIONING
A CASE REPORT
ABSTRACT
Excessive gingival display during smiling (“gummy smile”) with hyperpigmented gums is an esthetic concern for the patients. Gummy smile can be managed by different treatment modalities based on specific diagnosis. This case report demonstrates the management of a 22 years old female patient with the chief complaint of dark gums and excessive gingival display while smiling due to hypertonic lip. Treatment was planned in two stages which included melanin depigmentation with scalpel bilaterally and removal of strip of mucosa from maxillary buccal vestibule and suturing the lip mucosa to the mucogingival line (lip repositioning). Lip repositioning along with depigmentation resulted in significant improvement of smile with esthetic satisfaction of the patient.
Key words: Excessive gingival display, Gummy smile, Lip repositioning, Depigmentation
INTRODUCTION
Smile and facial expression are key components of nonverbal communication. An esthetic or pleasing smile is determined by the teeth, lip framework and the gingival scaffold.[1] Excessive gingival display (EGD), also called “gummy smile,” is one of several developmental
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Literature shows lip repositioning technique was first reported by Rubinstein and Kostianovsky[15] in the field of plastic surgery. The procedure was advocated again by Litton and Fournier[16] by performing myectomies to detach the smile muscle attachment to prevent relapse. Ellenbogen R et al.[17] used alloplastic or autogenous seperators to prevent reattachment of smile muscles and in some cases lip repositioning was used in conjunction with rhinoplasty.[10] Botulinum toxin injections were also used to treat excessive gingival

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