Presented modified lip repositioning surgery is a predictable technique for the treatment of excessive gingival display due to hyperactive upper lip, resulting in high level of patient satisfaction. Additional studies are necessary to evaluate the long-term outcomes of this procedure.
9. 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
Upper Lip- 0mm
Lower Lip- 2mmm
Upper Lip -0
Lower Lip -2
Menton -4
9
20. Thank for watching
For more details contact
Dr Arun George 09744873023
drarun1g@gmail.com
Director – The Dental Horizon
Muvattupuzha , India
Hinweis der Redaktion
Window p... Extend..... Presenter view
My special thx to Joby......... Secretary of IDA Malanadu.... For giving me 2 days this time....... For this presentation.......
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.
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.
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...........
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
Buccal Coridor
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
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
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.
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
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