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Clinical advantages of improving the excessive gingival display (EGD) by surgical repositioning of the upper lip

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Abstract

Objectives

The objective of this study is to minimize gingival display by surgical repositioning of the upper lip and to suggest this technique as an alternative treatment modality to orthognatic surgery for treatment of excessive gingival display.

Materials and methods

Forty-eight patients were selected with gingival display of more than 2 mm during maximal smiling. All patients underwent surgical repositioning of the upper lip, aimed at limiting elevator muscle activity to treat excessive gum exposure. Patients were regathered in 1 week for the follow-up postoperative symptoms according to VAS scale to evaluate pain and swelling. Reference values were given to patients.

Results

The study has indicated good results and stability especially to patients with skeletal class I classification along with medium and thick biotype of attached gingiva without hypermobile upper lip.

Conclusion

Surgical repositioning of the upper lip is an effective way to improve a patient’s gingival smile caused by degree I and II VME in combination with HUL as an alternative treatment modality to orthognathic surgery. This method is less invasive and cost-effective, causes minimal postoperative complications, and provides faster recovery.

Clinical relevance

Excessive gingival display (EGD) with various etiologies requires several proper treatment modalities. The proposed modified method of lip repositioning to reduce the degree of gingival display is less aggressive, reliable, and causes fewer postoperative complications compared to orthognathic surgery.

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Abbreviations

EGD:

Excessive gingival display

VME:

Vertical maxillary excess

HUL:

Hyperactive upper lip

CEJ:

Cemento enamel junction

MGJ:

Mucogingival junction

NSAIDs:

Non-steroidal anti-inflammatory drugs

MCPF:

Mucosal coronally positioned flap

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Mkhitar Heratsi Yerevan State Medical University, 0028 Kievyan str. 10 ap. 65, Yerevan, Armenia

    Gagik Hakobyan, Astghik Boyadjian, Armen Harutyunyan & Gegham Tunyan

  2. Boyadjian Dental Clinic, Mkhitar Heratsi Yerevan State Medical University, Yerevan, Armenia

    Mgrditch Boyadjian

  3. Department of Dental Professional and Continuing Education, Mkhitar Heratsi Yerevan State Medical University, Yerevan, Armenia

    Gagik Khachatryan

Authors
  1. Gagik Hakobyan
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  2. Astghik Boyadjian
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  3. Mgrditch Boyadjian
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  4. Armen Harutyunyan
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  5. Gegham Tunyan
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  6. Gagik Khachatryan
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Corresponding author

Correspondence to Gagik Hakobyan.

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Ethical approval

The study was reviewed and approved by the local Ethics Committee and in accordance with the norms of the World Medical Association and the Helsinki Declaration.

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The patients were informed about the study both verbally and in writing and provided their written consent for participation.

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The patient was properly informed and provided his/her written consent for publication of this case report and accompanying images.

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The authors declare no competing interests.

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Cite this article

Hakobyan, G., Boyadjian, A., Boyadjian, M. et al. Clinical advantages of improving the excessive gingival display (EGD) by surgical repositioning of the upper lip. Clin Oral Invest 26, 7265–7275 (2022). https://doi.org/10.1007/s00784-022-04687-4

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  • DOI: https://doi.org/10.1007/s00784-022-04687-4

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