Chirurgie du sourire gingivale et de la lèvre - - Winston Dental Clinic - Chirurgien-Dentiste à Bruxelles-Ixelles-Uccle
Lip positioning surgery for "Gummy smile"/Thin upper lip/Asymmetrical smile: A case report
This 53-year-old female has been a non-smoker for 10 years. Intraoral examination revealed excellent periodontal health and excellent restorative dentistry. An adequate vestibule and a good zone of attached gingiva were noted. Her lip length was 20mm (normal), the lower 1/3 of her face was proportional to the other thirds and there were no issues with her occlusal plane. Her smile was asymmetrical and lifting to the right side (7mm. gingiva showing on the right and about 5mm to tooth #23 on the left). Her upper lip was thin and stretched. She expressed an interest in showing less gingiva and having a fuller upper lip. She understood that her asymmetry was a genetic trait from her father. This patient had no health issues and no allergies to any medications. A diagnosis of hypermobile upper lip was made. She consented to surgery. The apical incision on the right side was made 2mm. wider than the left side. There was no swelling and little pain with the procedure. She was pleased with the result as the smile is now more symmetrical and the upper lip has appeared to have increased in volume. The result is stable at four months (Figs. 5 & 6).
This 45-year-old woman was a non-smoker. Her periodontal health was very good. She had extensive restorative therapy to correct her smile but remained extremely unhappy with her smile. She had an adequate vestibule and adequate attached gingiva. Her lip length was 22mm (normal) and the lower third of her face was proportional to the other thirds. There were no issues with her occlusal plane. She showed 8mm of gingiva with a full smile. She was also conscious of a thin upper lip. A diagnosis of hypermobile upper lip was made and she consented to surgery. She had little swelling or pain and was delighted with the result of the procedure. She was most pleased with the appearance of the upper lip, which had more than tripled in thickness after surgery (Figs. 7 & 8).
This 32-year-old female reported she has, “hated her smile since she was a young girl”. The only intra-oral issues noted were a rotated right lateral incisor and a retained deciduous tooth upper right segment (Impacted cuspid). Her main concern was her “gummy smile”. Restorative work to improve the appearance of #12 and the deciduous tooth would be done after the lip surgery. Examination showed a normal lip length and a proportional lower third of the face. This patient was in excellent health and was a non-smoker. Gingival tissues were on enamel and it was determined that crown lengthening would be required before lip surgery (Fig. 9). Crown lengthening was done (Fig. 10) and after only one week of healing, lip surgery was done (Fig. 11). The patient had little discomfort and was thrilled with the result (Figs. 10 & 13).
Dernière mise à jour le: 02/04/2021