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Erschienen in: Lasers in Dental Science 1/2023

31.01.2023 | Case Report

Lip repositioning and guided gingivectomy combined treatment for excessive gingival display by using 940-nm diode laser: a case report

verfasst von: Amal Ashry, Mohamed M. Khamis, Ahmed M. Abdelhamid, Lucette G. Segaan

Erschienen in: Lasers in Dental Science | Ausgabe 1/2023

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Abstract

Purpose

To report a predictable minimally invasive treatment approach for a gummy smile patient by using laser-assisted guided gingivectomy and lip repositioning.

Background

Excessive gingival display is one of the most common esthetic concerns that might affect the patient’s psychology and social life, especially in young age. For a long time, orthognathic surgery was recommended in spite of its high morbidity. Lip repositioning was the treatment of choice for many patients as it was effective for the reduction of gingival display, a safe and less invasive procedure. Although, due to the multifactorial origin of gummy smile, combined treatment protocols are usually required. Besides, the patients demand reduced pain following procedures as well as predictable outcomes.

Case report

A 20-year-old male patient was requesting a treatment for his gummy smile. Upon examination, 7-mm gingival display was reported with a multifactorial origin. A 3D-printed computerized gingivectomy guide was fabricated based on the smile design for the patient by using the cone beam computed tomography, extraoral and intraoral photographs. A 940-nm diode laser in a continuous wave mode and with a power of 1.5 W was used for the gingivectomy and lip repositioning. The procedure was performed under local anesthesia with no bleeding or post-operative complications reported.

Conclusion

The combined treatment approach by using computer-guided gingivectomy and lip repositioning by using 940 diode laser was effective to provide predictable outcomes for treatment of gummy smile with minimal bleeding, uneventful healing, and minimal postoperative pain.
Literatur
1.
Zurück zum Zitat Dos Santos-Pereira SA, Cicareli ÁJ, Idalgo FA, Nunes AG, Kassis EN, Castanha Henriques JF, Bellini-Pereira SA (2021) Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: a systematic review and meta-analysis. J Esthetic Restor Dent : Official Public Am Acad Esthetic Dentistry [et al] 33(3):446–457CrossRef Dos Santos-Pereira SA, Cicareli ÁJ, Idalgo FA, Nunes AG, Kassis EN, Castanha Henriques JF, Bellini-Pereira SA (2021) Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: a systematic review and meta-analysis. J Esthetic Restor Dent : Official Public Am Acad Esthetic Dentistry [et al] 33(3):446–457CrossRef
2.
Zurück zum Zitat Mendoza-Geng A, Gonzales-Medina K, Meza-Mauricio J, Muniz F, Vergara-Buenaventura A (2022) Clinical efficacy of lip repositioning technique and its modifications for the treatment of gummy smile: systematic review and meta-analysis. Clin Oral Investig 26(6):4243–4261 Mendoza-Geng A, Gonzales-Medina K, Meza-Mauricio J, Muniz F, Vergara-Buenaventura A (2022) Clinical efficacy of lip repositioning technique and its modifications for the treatment of gummy smile: systematic review and meta-analysis. Clin Oral Investig 26(6):4243–4261
3.
Zurück zum Zitat Andijani RI, Tatakis DN (2019) Hypermobile upper lip is highly prevalent among patients seeking treatment for gummy smile. J Periodontol 90(3):256–262CrossRefPubMed Andijani RI, Tatakis DN (2019) Hypermobile upper lip is highly prevalent among patients seeking treatment for gummy smile. J Periodontol 90(3):256–262CrossRefPubMed
4.
Zurück zum Zitat Polo M (2022) Gummy smile treatment: a 40-year journey. AJO-DO Clinical Companion 2(2):125–135CrossRef Polo M (2022) Gummy smile treatment: a 40-year journey. AJO-DO Clinical Companion 2(2):125–135CrossRef
5.
Zurück zum Zitat Dym H, Pierre R 2nd (2020) Diagnosis and treatment approaches to a “gummy smile.” Dent Clin North Am 64(2):341–349CrossRefPubMed Dym H, Pierre R 2nd (2020) Diagnosis and treatment approaches to a “gummy smile.” Dent Clin North Am 64(2):341–349CrossRefPubMed
6.
Zurück zum Zitat Kostianovsky AS, Rubinstein AM (1976) The “unpleasant” smile. Aesthetic Plast Surg 1(1):161–166CrossRefPubMed Kostianovsky AS, Rubinstein AM (1976) The “unpleasant” smile. Aesthetic Plast Surg 1(1):161–166CrossRefPubMed
7.
Zurück zum Zitat Andijani RI, Paramitha V, Guo X, Deguchi T, Tatakis DN (2021) Lip repositioning surgery for gummy smile: 6-month clinical and radiographic lip dimensional changes. Clin Oral Invest 25(10):5907–5915CrossRef Andijani RI, Paramitha V, Guo X, Deguchi T, Tatakis DN (2021) Lip repositioning surgery for gummy smile: 6-month clinical and radiographic lip dimensional changes. Clin Oral Invest 25(10):5907–5915CrossRef
8.
Zurück zum Zitat Faus-Matoses V, Faus-Matoses I, Jorques-Zafrilla A, Faus-Llácer VJ (2018) Lip repositioning technique A simple surgical procedure to improve the smile harmony. J Clin Exp Dent 10(4):e408–e412PubMedPubMedCentral Faus-Matoses V, Faus-Matoses I, Jorques-Zafrilla A, Faus-Llácer VJ (2018) Lip repositioning technique A simple surgical procedure to improve the smile harmony. J Clin Exp Dent 10(4):e408–e412PubMedPubMedCentral
9.
Zurück zum Zitat Kazakova RT, Tomov GT, Kissov CK, Vlahova AP, Zlatev SC, Bachurska SY (2018) Histological gingival assessment after conventional and laser gingivectomy. Folia Med 60(4):610–616CrossRef Kazakova RT, Tomov GT, Kissov CK, Vlahova AP, Zlatev SC, Bachurska SY (2018) Histological gingival assessment after conventional and laser gingivectomy. Folia Med 60(4):610–616CrossRef
10.
Zurück zum Zitat Capodiferro S, Kazakova R (2022) Laser-assisted gingivectomy to treat gummy smile. Dent Clin North Am 66(3):399–417CrossRefPubMed Capodiferro S, Kazakova R (2022) Laser-assisted gingivectomy to treat gummy smile. Dent Clin North Am 66(3):399–417CrossRefPubMed
11.
Zurück zum Zitat Khamis M, Abdelrehim A (2019) Interdisciplinary management of a patient with a gummy smile. J Oral Maxillofacial Radiol 7(2):38–43CrossRef Khamis M, Abdelrehim A (2019) Interdisciplinary management of a patient with a gummy smile. J Oral Maxillofacial Radiol 7(2):38–43CrossRef
12.
Zurück zum Zitat Liu X, Yu J, Zhou J, Tan J (2018) A digitally guided dual technique for both gingival and bone resection during crown lengthening surgery. J Prosthet Dent 119(3):345–349CrossRefPubMed Liu X, Yu J, Zhou J, Tan J (2018) A digitally guided dual technique for both gingival and bone resection during crown lengthening surgery. J Prosthet Dent 119(3):345–349CrossRefPubMed
13.
Zurück zum Zitat Arias DM, Trushkowsky RD, Brea LM, David SB (2015) Treatment of the patient with gummy smile in conjunction with digital smile approach. Dent Clin North Am 59(3):703–716CrossRefPubMed Arias DM, Trushkowsky RD, Brea LM, David SB (2015) Treatment of the patient with gummy smile in conjunction with digital smile approach. Dent Clin North Am 59(3):703–716CrossRefPubMed
14.
Zurück zum Zitat Ebrahimi P, Hadilou M, Naserneysari F, Dolatabadi A, Tarzemany R, Vahed N, Nikniaz L, Fekrazad R, Gholami L (2021) Effect of photobiomodulation in secondary intention gingival wound healing-a systematic review and meta-analysis. BMC Oral Health 21(1):258CrossRefPubMedPubMedCentral Ebrahimi P, Hadilou M, Naserneysari F, Dolatabadi A, Tarzemany R, Vahed N, Nikniaz L, Fekrazad R, Gholami L (2021) Effect of photobiomodulation in secondary intention gingival wound healing-a systematic review and meta-analysis. BMC Oral Health 21(1):258CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Mossaad AM, Abdelrahman MA, Kotb AM, Alolayan AB, Elsayed SA (2021) Gummy smile management using diode laser gingivectomy versus botulinum toxin injection - a prospective study. Annals of maxillofacial surgery 11(1):70–74CrossRefPubMedPubMedCentral Mossaad AM, Abdelrahman MA, Kotb AM, Alolayan AB, Elsayed SA (2021) Gummy smile management using diode laser gingivectomy versus botulinum toxin injection - a prospective study. Annals of maxillofacial surgery 11(1):70–74CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Abdelhafez RS, Rawabdeh RN, Alhabashneh RA (2022) The use of diode laser in esthetic crown lengthening: a randomized controlled clinical trial. Lasers Med Sci 37(5):2449–2455 Abdelhafez RS, Rawabdeh RN, Alhabashneh RA (2022) The use of diode laser in esthetic crown lengthening: a randomized controlled clinical trial. Lasers Med Sci 37(5):2449–2455
17.
Zurück zum Zitat Kim HR, Son K, Son YT, Kim YG, Lee KB, Lee SC, Suh JY, Lee JM (2022) A comparative immunohistochemical study of wound healing after dental diode laser treatment in the rat oral mucosa. Bioengineering (Basel, Switzerland) 9(9):466PubMed Kim HR, Son K, Son YT, Kim YG, Lee KB, Lee SC, Suh JY, Lee JM (2022) A comparative immunohistochemical study of wound healing after dental diode laser treatment in the rat oral mucosa. Bioengineering (Basel, Switzerland) 9(9):466PubMed
18.
Zurück zum Zitat Yildiz MS, Gunpinar S (2019) Free gingival graft adjunct with low-level laser therapy: a randomized placebo-controlled parallel group study. Clin Oral Invest 23(4):1845–1854CrossRef Yildiz MS, Gunpinar S (2019) Free gingival graft adjunct with low-level laser therapy: a randomized placebo-controlled parallel group study. Clin Oral Invest 23(4):1845–1854CrossRef
Metadaten
Titel
Lip repositioning and guided gingivectomy combined treatment for excessive gingival display by using 940-nm diode laser: a case report
verfasst von
Amal Ashry
Mohamed M. Khamis
Ahmed M. Abdelhamid
Lucette G. Segaan
Publikationsdatum
31.01.2023
Verlag
Springer International Publishing
Erschienen in
Lasers in Dental Science / Ausgabe 1/2023
Elektronische ISSN: 2367-2587
DOI
https://doi.org/10.1007/s41547-023-00174-5

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