Clinical Management of Excessive Gingival Display with Lip Repositioning Surgery: A Case Report

Abstract

Excessive gingival display (EGD), commonly termed "gummy smile," is characterized by the visibility of more than 2 mm of gingival tissue during smiling, creating aesthetic concerns especially prevalent among women. The etiology of EGD can be single or multifactorial, encompassing dentoalveolar factors such as gingival hypertrophy, altered passive eruption, short dental crowns, as well as non-dentoalveolar factors like vertical maxillary excess and hyperactive upper lip. Accurate identification of the underlying cause is critical for selecting an appropriate treatment modality. Lip repositioning surgery (LRS), presents a conservative, minimally invasive alternative to more extensive orthognathic surgeries. This paper describes the application of LRS in managing EGD associated with hyperactive upper lip movements. The described case involves a 36-year-old female patient exhibiting symmetrical facial proportions, competent lips, and gingival exposure exceeding the esthetic threshold. Surgical intervention involved partial-thickness incisions and mucosal excision to limit muscle contractions responsible for the excessive gingival display. Postoperative evaluations revealed significant aesthetic improvement with minimal morbidity and high patient satisfaction. LRS, therefore, emerges as an effective, safe, and predictable technique, suitable for mild to moderate cases of EGD, offering sustainable short-term outcomes. Further research and long-term evaluations are recommended to assess procedure stability and effectiveness comprehensively.