Case series of laser-assisted treatment of excessive gingival display: an alternative treatment

Photomed Laser Surg. 2014 Sep;32(9):517-23. doi: 10.1089/pho.2014.3737. Epub 2014 Jul 23.

Abstract

Objective: The objective of this study was to investigate the stable and significant outcomes of laser-assisted lip repositioning technique for the treatment of excessive gingival display.

Background data: "Gummy smile" is a major concern for a large number of patients visiting the dentist. The hyperactivity of the upper lip is one of the main causes of a gummy smile, and several techniques have been proposed for its treatment.

Methods: Ten patients with excessive gingival display were treated with laser-assisted lip repositioning technique. The technique is composed of removing a strip of mucosa by laser incisions from the maxillary buccal vestibule, and coronal repositioning of the new mucosal margin. The clinical dimensions of gingival display were measured from the left, right posterior, and anterior sides at baseline, 6 and 12 months postoperatively. Subjects completed surveys to evaluate satisfaction with outcomes. Clinical and patient-centered parameters [visual analog scale for pain and aesthetics (VAS)] were measured at 7 days and again at 12 months after the surgery.

Results: The baseline anterior gingival display of 4.3±1.8 mm significantly decreased to 1.1±1.0 mm at 6 months (p<0.0001) and was maintained at 12 months (1.2±1.5 mm). The baseline left, right gingival display (4.9±2.2 mm; 5.0±1.4 mm) significantly decreased (1.2±1.4 mm; 1.3±1.1 mm) at 12 months (p<0.0001). Patients were satisfied with their smile after surgery and would likely choose to undergo the procedure again.

Conclusions: The treatment of gummy smile with laser-assisted lip repositioning successfully reduced the preoperative gingival display without postoperative complications, in all cases.

MeSH terms

  • Adult
  • Esthetics, Dental
  • Female
  • Gingivectomy / methods*
  • Humans
  • Laser Therapy / methods*
  • Lip / surgery*
  • Male
  • Pain Measurement
  • Patient Satisfaction
  • Smiling*
  • Treatment Outcome