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Lip repositioning surgery for gummy smile: 6-month clinical and radiographic lip dimensional changes

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Abstract

Objectives

The present case series aimed to examine lip repositioning surgery (LRS) outcomes related to changes in external and internal upper lip (UL) dimensions, utilizing both conventional clinical and novel radiographic approaches.

Materials and methods

Patients (n = 13) diagnosed with hypermobile UL (>8-mm mobility during smile) and excessive gingival display (≥4-mm) were included and assessed at baseline and 6 months postoperatively. Clinical parameters at rest included total lip and internal lip length (vestibular depth). At maximum smile included total lip, philtrum (ergotrid), and vermilion lengths. Cephalometric parameters included anterior maxillary height; lip length; nasolabial angle; anteroposterior lip thickness; internal lip length (vestibular depth); and vestibular fornix position (using novel approach employing radiopaque marker). Linear mixed-effect models, Pearson’s correlation, and linear regression were used for statistical analyses.

Results

LRS did not affect total UL length at rest (p = 0.418). It resulted in significant internal UL length decrease (−3.8 ± 2.1 mm, p < 0.001) and significant increases of vermilion length (1.9 ± 1.0 mm, p < 0.001) and anteroposterior lip thickness (0.7 ± 0.7 mm, p = 0.002). The clinical and radiographic measurements of total UL length at rest (r ≥ 0.734) and of internal UL length (r ≥ 0.737), and the two radiographic assessments of vestibular depth (r = 0.842), were strongly correlated.

Conclusions

LRS resulted in significant decrease of vestibular depth/internal UL length and in significant increases of UL vertical vermilion length and UL anteroposterior thickness, without affecting total UL length at rest.

Clinical relevance

The documented lip dimensional outcomes should help practitioners when treatment-planning LRS and counseling patients seeking treatment for hypermobile UL.

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Data availability

Supporting data of this study are available from the corresponding author upon request.

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Acknowledgements

The authors thank Ms. Laura McCallister, from the Division of Periodontology, The Ohio State University, for her expert assistance with logistics and editorial support.

Funding

This study was supported by the authors’ institution (Division of Periodontology, College of Dentistry, The Ohio State University, in Columbus, Ohio, USA).

Author information

Authors and Affiliations

  1. Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH, 43210, USA

    Reem I. Andijani, Vanessa Paramitha & Dimitris N. Tatakis

  2. Dentistry Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia

    Reem I. Andijani

  3. Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA

    Xiaohan Guo

  4. Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA

    Toru Deguchi

Authors
  1. Reem I. Andijani
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  2. Vanessa Paramitha
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  3. Xiaohan Guo
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  4. Toru Deguchi
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  5. Dimitris N. Tatakis
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Corresponding author

Correspondence to Dimitris N. Tatakis.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Supplementary information

Supplementary Fig. 1

Lip repositioning surgery. A) Preoperative image with marked incision outline. B) After removal of mucosal strip. C) After surgery completion. (JPG 1485 kb)

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Andijani, R.I., Paramitha, V., Guo, X. et al. Lip repositioning surgery for gummy smile: 6-month clinical and radiographic lip dimensional changes. Clin Oral Invest 25, 5907–5915 (2021). https://doi.org/10.1007/s00784-021-03896-7

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  • DOI: https://doi.org/10.1007/s00784-021-03896-7

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