A normal healthy gingiva appears coral pink, but physiologic variations may produce pigmented patches
Smile is an important determinant of the facial attractiveness of an individual. A perfect smile is an immaculate harmony between the pink gums and the white teeth. A normal smile has 1–2 mm of gingival display from the lower border of upper lip to the gingival margin of upper central incisors. Greater than 4 mm of gingival display is aesthetically not pleasing for most patients and is known as excessive gingival display (EGD) leading to a gummy smile (GS).
A disturbance in the color of the gingiva gets highlighted in an individual with GS. A normal healthy gingiva appears coral pink, but physiologic variations may produce pigmented patches. Gingival depigmentation is a procedure performed to eliminate the pigmented superficial gingival epithelium.
When a person smiles, the crowns of maxillary central incisors and 1 mm of pink attached gingiva are evident. Approximately 2–3 mm of exposed gingiva can be cosmetically acceptable if it is not unduly conspicuous. In most patients, the lower edge of the upper lip assumes a “gum-wing” profile, which limits the amount of gingiva that is exposed when a person smiles. Patients with high lip line expose a broad zone of gingiva, resulting in Gummy Smile.
The various causes of gummy smile include vertical maxillary excess, anterior dentoalveolar extrusion, altered passive eruption, short or hyperactive upper lip, or combinations thereof. Treatment of EGD by esthetic crown lengthening with or without osseous resection is well documented. Dentoalveolar extrusion can be treated successfully by orthodontic therapy. EGD, due to vertical maxillary excess, can be successfully treated by Orthognathic surgery. However, this surgery is associated with significant morbidity and requires hospitalization. Therefore, lip repositioning is recommended as an alternative treatment for Excessive Gum Display. The objective of lip repositioning is to limit the retraction of elevator smile muscles. Lip repositioning results in shallow vestibule restricting the muscle pull thereby limiting the gingival display during smiling.
It is a surgical technique mainly done to increase the length of the lip and thereby reducing the excess gingival show and creating a better smile. Due to the excess pull of the muscles and due to bony discrepancies there will be an excess gingival display that will lead to functional as well as aesthetic discrepancies, hence to correct these deformities a specialist oral and maxillofacial surgeon and team will increase the length thereby reframing the size of the lip thus creating a balanced proportion with the face.
We at FMS have a well defined strategy and protocol before preparing a patient for any surgical intervention firstly explaining the patient about the procedure, how it’s done, before surgery assessments, after surgery instructions clearly and thus relieving the patients from the big fear of surgery. All discussions, planning of the surgery and the desired outcome will be in prior informing to the patient and thereby giving clarity of the entire procedure and patient can walk into FMS with zero fear.
It’s a minor oral surgical procedure which will be done by the team of senior ORAL AND MAXILLOFACIAL SURGEONS at FMS with over 20 years of experience in the field of oral and maxillofacial surgery. Adequate planning and strictly followed FMS PROTOCOL will be maintained for the patient from the time of walk in to our clinic till the healing period to ensure a proper and sound healing of the surgical site along with a happy smile for the patient.
Yes we do understand that surgery has its own morbidity and complications and might have little discomfort to the patient compared to non surgical interventions that makes the patient corner towards non surgical interventions. The need for patients to look more aesthetically appealing has led to the cosmetic side of dentistry to flourish more in the recent years. Some of the procedures like smile designing, veneers; teeth whitening have been conventionally done to improve the aesthetic appearance of the individual. A recent trend is the use of Botox, fillers, PRP, facelift etc. One such cosmetic procedure is the use of Botox injections for the treatment of gummy smile.
Botulinum toxin (BTX) produced by Clostridium botulinum is a neurotoxin protein. It causes flaccid paralysis, by preventing the release of acetylcholine at the neuromuscular junction. Botox is used to treat many muscular disorders. Overactive muscle movement like in Cerebral palsy, post-stroke spasticity, and post spinal-cord injury spasticity can be managed by Botox administration. Botox has been used in dentistry to treat bruxism, TMDs, hemi-facial spasm, Massetric hypertrophy etc. It can also be used to treat gummy smiles by paralyzing the elevator muscles of the upper lip.
D. There will be full time assistance throughout the post operative period thereby ensuring a faster healing and avoiding less or zero complications.
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