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Abstract

Gingival display greater than 3 mm results in a situation termed as gummy smile and this situation is often esthetically unacceptable for the individual. Different techniques have been used in case of hiperactive upper lip: botulinum toxin injections, lip elongations with rhinoplasties, lip muscle detachments, myotomies and lip repositionings. We aimed to a present a case of a female patient with excesssive gingival display treated using reverse vestibuloplasty. 47 year old female patient came to our periodontology clinics complaining of an unesthetic excessive gingival display more than 10 mm. A treatment model combining of crown lenghtening procedures, reverse vestibuloplasty and esthetic prosthetic rehabilitation was planned. After local anesthesia, a horizontal incision from right upper molar to the left upper molar was made in the mucogingival juncion. A paralel horizontal incison was also made 10 mm coronally and two vertical incisions were made in the most distal parts of the flap design. Half-thickness flap was reflected and tissue was removed. Two horizontal incision lines were connected using simple suttures, so the upper lip was not excessively mobile any longer. Crown-lenghtening procedures were also performed. After one week, suttures were removed. Healing was uneventful. About a month later, esthetic prosthetic rehabilitation was performed. High-level patient satisfaction was achieved. Discussion: Different techniques could also be combined in the existence of gummy smile. Conclusion/clinical significance: Reverse vestibuloplasty is a minimal invasive surgical procedure with satisfying esthetic results as an alternative to orthognatic surgery.

Keywords: Excessive gingival display; Gummy smile; Reverse vestibuloplasty