Efficacy of a Modified Lip Repositioning Surgery Technique With Tie Levator Labii Superioris and Without Frenectomy and Myotomy for Treatment of Excessive Gingival Display

Not Applicable

Completed

• Conditions: Excessive Gingival Display

• Registration Number: NCT06944535
• Lead Sponsor: Can Tho University of Medicine and Pharmacy

Brief Summary

The objective of this prospective study was to investigate a modified lip repositioning surgery technique with tie labii superioris and without frenectomy and myotomy for the treatment of excessive gingival display

Detailed Description

Excessive gingival display (EGD), commonly referred to as a "gummy smile" (GS), is one of the most common deformities and conditions of the gingival mucosa around teeth and can be a significant aesthetic concern for some individuals, leading them to seek treatment. The presence of EGD/GS has a negative impact on the patient's oral health-related quality of life, including aspects of functional limitation, psychological distress, psychological disability, and social disability. Successful treatment of Excessive gingival display with the lip repositioning surgery (LRS) has been reported in the literature. The last few years have seen the introduction of new techniques for altered passive eruption (APE) and hypermobile upper lip (HUL)management, an expansion of the available aesthetic crown lengthening (ACL) and LRS variations, and additional evidence further supporting the effectiveness of these two procedures. Several of the recently introduced approaches offer unique, innovative, and potentially impactful concepts. However, for many of these newly described treatments the available evidence is limited to case reports and the exact indications remain to be adequately defined. The literature lacks adequate clinical trials of LRS with sufficient follow-up time. Nevertheless, in regards to gingival display GD reduction, a recent systematic review found a mean reduction of 3.4 mm with a median follow-up time of 6 months. Some research found significant increase in upper lip length and upper lip vermilion length 6-months post-operative PO. Moreover, some case reports of LRS mentioned fuller upper lip appearance after treatment. Excessive gingival display, or "gummy smile", can be successfully managed through various surgical approaches that must be chosen based on the underlying etiology and clinical characteristics of each case. Therefore, this study aimed to explore the efficacy outcomes of a lip repositioning technique for the treatment of excessive gingival display

Study Timeline

• Status Verified: 2023-09
• Study Start: 2023-09-12
• Primary Completion: 2024-09-12
• Study Completion: 2024-09-20
• Study First Submitted: 2025-04-07
• Study First Submitted QC: 2025-04-17
• Last Update Submitted: 2025-04-17
• Study First Posted: 2025-04-25
• Last Update Posted: 2025-04-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• Adults (>18 years old)
• Systemically healthy
• No medication intake
• Nonsmoker
• Periodontally healthy
• Maxillary anterior teeth of normal dimensions
• Normal upper lip length (females: 20-22 mm; males: 22-24 mm) hyperactive upper lip (lip mobility >8 mm) and gingival display > 4mm during smile

Exclusion Criteria

The patient has trauma and facial deformities

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
The objective of this prospective study was to investigate outcomes of a lip repositioning technique for the treatment of excessive gingival display	The following parameters were assessed from clinical photographs obtained during active smile, with a mm ruler in place, and were recorded at baseline, 3 and 6 months	Treatment consisted of the removal of two strips of mucosa, bilaterally to the maxillary labial frenum and coronal repositioning of the new mucosal margin. Patients held a customized, disposable ruler at a site distal to the maxillary right central incisor, and frontal photos were taken at rest and at maximum smile positions. The photos of each patient at the different time lines were analyzed using Microsoft Paint software (Version 5.5.1, Microsoft Corporation, USA and ImageJ software (Version v1.51j8, National Institutes of Health, USA). For every baseline photo, reproducible lines with certain reference points were drawn using Paint software then represented in the 3 and 6 months PO photos.

Trial Locations

Locations (1)

Can Tho University of Medicine and Pharmacy; 🇻🇳 Cần Thơ, Vietnam