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Lip repositioning surgery for Gummy Smile Correction
- 1. Dr Arun GeorgeMDS Maxillofacial Surgeon India drarun1g@gmail.com Lip Repositioning Surgery for Gummy Smile Correction
- 2. Orthodontics – 6mm, Orthopaedicsplus Ortho _ 12 mm Orthognathics - 1.5 cm Distraction- 2.5cm Distraction - 2.5 cm 2
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- 5. NORMAL VALUE 1-3 mmis acceptable 5
- 6. 1:1.618 Golden Proportion brown skin fulllips Larger distance between the eyes darker eyelashes darker eye brows high cheek bones narrow nose. 6
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- 9. The clinical FHplane is the line from the tragus of the ear to the bony infraorbital rim. The evaluation is preferably done with the line parallel to the floor. This is often the natural head Upper Lip- 0mm Lower Lip- 2mmm Upper Lip -0 Lower Lip -2 Menton -4 9
- 10. Gummy Smile ??? TreatmentOptions • Teeth intrusion • Crown lengthening • Botox Injection • Orthognathics
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- 14. After partial thicknessflap excision
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- 16. Tight wound closurefor lowering the gums
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- 20. Thank for watching Formore details contact Dr Arun George 09744873023 drarun1g@gmail.com Director – The Dental Horizon Muvattupuzha , India
Editor's Notes
- #2 Window p... Extend..... Presenter view My special thx to Joby......... Secretary of IDA Malanadu.... For giving me 2 days this time....... For this presentation.......
- #3 Comparison of All diffferent modalities of treatment. The centre represents the final position after the treatment. The outer circle represents the amount of movement that can be achieved by surgery, the middle represents the result from myofunctional appliance and the inner circle represents the orthodontic movement. The segmental part represents the advancement that can be achieved by distraction osteogenesis.
- #4 Causes of Gummy Smile Vertical Maxillary Excess Anterior Dentoalveolar Extrusion Short Upper Lip Hyperactive upper lipS The appearance of a “gummy smile” is a condition that affects as much as 10% of the young adult population. Technically known as Excess Gingival Display, the visual presence of too much gum tissue when you smile can be caused by a number of factors. While some patients may have simply developed an overabundance of gum tissue, others may have excess bone structure in the front portion of the upper jaw. The condition can also be attributed to a particularly short upper lip or an upper lip that tends to retract too much during a full smile. Women appear to be affected by Excess Gingival Display twice as often as men, and the condition seems to be more prevalent in the African-American population.
- #5 Border line to extreme cases of Gummy Smile. When we have gummy smile due to skeletal problems... The treatment options are based on the principles of Orthognathic surgery...........
- #6 Normally upper lip is expected to lie in line with the incisal margin of the upper anteriors. However up to 3mm of exposure ( 25% of the length of incisors) may be considerd normal. More than this is considerd as vertical excess of maxilla
- #8 Buccal Coridor
- #10 Subnasale perpendicular to the FHP is to be considerd as an important criterion for profile analysis and identifying the sagital deformities of the face.In a natural head position the profile line in relation to the clinical FH plane can be assessed. It could be straight or divergent posteriorly or anteriorly. The clinical FH plane is the line from the tragus of the ear to the bony infraorbital rim. The evaluation is preferably done with the line parallel to the floor. This is often the natural head position.The upper lip vermilion border is almost in line with the subnasale perpendicular while the lower lip vermilion is about 2mm behind and soft tissue menton about 4mm behind the sn perpendicular. The Frankfurt plane (also called the auriculo-orbital plane) was established at the World Congress on Anthropology in Frankfurt,Germany in 1884, and decreed as the anatomical position of the human skull. It was decided that a plane passing through the inferior margin of the left orbit (the point called the left orbitale) and the upper margin of each ear canal or external auditory meatus, a point called the porion, was most nearly parallel to the surface of the earth, and also close to the position the head is normally carried in the living subject
- #11 Orthodontic Intrusion Gingivectomy - Botulinum Toxide Injections – they are neurosensory modulator drug which weakens the muscle and the results lasts to 4 to 6 months Orthognathic Surgery
- #13 A male patient aged 28 years reported with a chief complaint of gummy smile and was treated with this technique performed under local anesthesia with the main objective to reduce gummy smile by limiting the retraction of elevator muscles (e.g., zygomaticus minor, levator anguli, orbicularis oris, and levator labii superioris). The technique is fulfilled by removing a strip of mucosa from maxillary buccal vestibule and creating a partial thickness flap between mucogingival junction and upperlip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display.
- #15 Patient was operated 8 months back The surgical procedure was initiated followed by local anaesthesia Partial thickness horizontal incision was placed 1 mm above the mucogingival line from first molar to first molar region The strip of outlined mucosa was removed by a superficial split thickness dissection leaving the connective tissue exposed Continuous interlocking sutures were placed to stabilize the new mucosal margin to gingiva
- #18 The surgical procedure was initiated followed by local anaesthesia Partial thickness horizontal incision was placed 1 mm above the mucogingival line from first molar to first molar region The strip of outlined mucosa was removed by a superficial split thickness dissection leaving the connective tissue exposed Continuous interlocking sutures were placed to stabilize the new mucosal margin to gingiva