Impact of orthognathic surgery on the treatment of gummy smile: an integrative review

The gingival smile is considered unpleasant and can be treated in different ways according to its etiological factor. When caused by maxillary vertical growth excess, orthognathic surgery may be indicated to correct the vertical excess. The aim of this integrative review was to evaluate the impact of orthognathic surgery on the treatment of gingival smile. An electronic search was performed of the PubMed/Medline, Cochrane Library, Scopus, and Google Scholar databases. The selection of studies was performed by two blinded reviewers. Firstly, studies were selected by reading the titles and the abstracts of articles. The references from each study selected were then searched to find articles that were not found in the electronic search. After reading the full-text articles, studies that met the inclusion criteria were selected. A total of 667 studies were identified, but only 19 were selected for the integrative review after applying the inclusion and exclusion criteria. The selected articles reported maxillary impaction from 2 to 10 mm, but this amount of superior repositioning of maxilla does not appear to be related to the initial gingival exposure described. Orthognathic surgery is not the first choice of treatment for gingival smile, but it appears to be a suitable therapy for other conditions in the same patient for improving a gummy smile by correction of gingival exposure.