Author : Lobna Abdelaziz
CoAuthors : LOBNA ABDELAZIZ ALY AHMED, Nelly Ibrahim Hammouda Ibrahim
Source : Dental research Journal
Date of Publication : 07/2016
Abstract :
Background: Excessive gingival display is a frequent finding that can occur because of various intraoral or extraoral etiologies. This work describes the use of a mucosal repositioned flap for the management of a gummy smile associated with vertical maxillary excess and hypermobility of the upper lip followed by injection of Botox .
Methods: Seven female patients between the age group of 17 to 25 years presented with a gummy smile. At full smile the average gingival display ranged from 6 to 8 mm. A clinical examination revealed hypermobility of the upper lip .A cephalometric analysis pointed to the presence of vertical maxillary excess. The mucosal repositioned flap surgery was conducted followed by injection with Botulinum toxin type A (Botox) 2 weeks post surgically.
Results: After 4 weeks results were definitely observed with a decrease from 8 mm gingival exposure to 3 mm, which was considered as normal gingival display for an adult during smiling.
Conclusion: For patients desiring a less invasive alternative to orthognathic surgery, the mucosal repositioned flap is a viable alternative. Also, Botox be a useful adjunct to enhance the aesthetics and improve patient satisfaction where surgery alone may prove inadequate in moderate vertical maxillary excess.
Keywords: gummy smile, lip repositioning, Botox.
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