A Case Report of Improvement of Gummy Smile Using Lip Repositioning Technique followed up for one year

Case overview: The authors report here a case in which the lip repositioning technique was used to correct a gummy smile caused by hyperactive upper lip, which was followed for one year and resulted in a satisfactory outcome. The patient was a 24-year-old female who presented with a chief complaint of excessive gingival display. She had no systemic health issues, and no inflammation of the gingiva was observed. When she smiled, 8 mm of the gingiva was exposed above the maxillary anterior teeth. Based on clinical test findings, she was diagnosed with gummy smile caused by hyperactive upper lip.Treatment plan: Prior to carrying out lip repositioning, a reversible trial was conducted in which no tissue was resected. The patient was observed for one week, after which a decision was made to carry out lip repositioning.Course of treatment and treatment outcome: The modified lip repositioning technique was performed, which avoids postoperative left-right asymmetry by preserving the upper labial frenum. Following surgery, the patient was instructed to limit movement of the lips. When the stitches were removed one week later, the patient was experiencing pain, swelling and subcutaneous bleeding. One month later, the symptoms had disappeared, and exposure of the gingiva above the maxillary anterior teeth was improved 8 mm to 1 mm when the patient smiled. No complications such as asymmetry of the lip were observed. The patient was followed for one year, during which no regression was observed, and made steady progress that resulted in a high degree of patient satisfaction.Discussion and conclusion: Gummy smile presents aesthetic problems. There are various treatment methods by which gummy smile can be addressed, and there is room for debate regarding cases in which the lip repositioning technique can be applied and the long-term prognosis. Conducting a reversible trial enables better anticipation of the outcome, and if based on an accurate diagnosis, the lip repositioning technique offers advantages compared to prosthodontics and surgical orthodontic treatment in terms of treatment period, invasiveness and other factors.