Background. Orthodontists today have to meet their patients’ increasing demand for esthetic satisfaction. This quest for youth and beauty is a new development in orthodontics, leading practitioners to try to discern the elements that determine facial esthetics and to set out rules and principles. The essential factor in this demand doubtless concerns a youthful and harmonious smile. Excessive gingival display in smiling may make the smile displeasing or even repulsive. Correcting ‘ ‘ gummy smile’ ’ thus becomes a prime treatment objective in response to patient demand Assessment should therefore seek the etiology of gummy smile, as this will determine optimal treatment, which is usually orthodontic or orthodontic and surgical. Which cases call for one approach or the other? This is the question the present articles seeks to answer. Methods. To analyze the effects of different treatments, measurements were made on pre-and posttreatment lateral teleradiographs in 20 patients Results. Although moderate gummy smile ( Conclusions. Case studies have shown that, according to the type of treatent, esthetic, dento-alveolar and skeletal consequences differ.

Background and Aim: The most esthetic smile is when the entire length of the crown of the tooth and 2 mm of the gums are visable. Most of it is not aesthetically pleasing and is called gummy smile or gingival smile. Upper lip length is one of the factors influencing the gummy smile. The aim of the present study was to investigate the upper lip length in patients with vertical growth pattern, with and without gummy smile and related factors. Materials and methods: This cross-sectional study was performed on 180 patients referred to the dental clinic of Tehran Dental Branch of Islamic Azad University. Patients were randomly divided into three groups vertical growth pattern (VGP), Average growth pattern (AGP) and gummy smile. The length of the upper lip in all three groups was measured and compared by the caliper. T test, ANOVA and Tukey tests were used to compare the data. Results: In both sexes (men and women), the mean upper lip length was significantly higher in patients with vertical growth pattern without gummy smile than patients with normal growth pattern (P<0. 001) and in patients with vertical growth pattern with gummy smile (P<0. 001). In people with a normal growth pattern (P<0. 001) and in people with a vertical growth pattern with gummy smile (P = 0. 004), the mean length of the upper lip in men was significantly higher than in women. However, in people with a normal growth pattern without gummy smile, the mean length of the upper lip in men was not significantly different from that in women (P = 0. 139). Conclusion: Gender vertical growth pattern, and gender interaction with vertical growth pattern affect the upper lip length. The pattern of vertical growth affects the parameters of the smile in people with gummy smile.

For many years oral esthetic problems treated by dentists were limited to those involving the teeth without giving consideration to the gingiva. However, today it is well established that these structures should be in balance to appear esthetically pleasing. More than 3mm gingival show during smiling is considered as ‘ excessive gingival display’ also known as “ gummy smile” , which is not attractive. The current case series, presents three patients with gummy smile managed by lip repositioning surgery, each with 1 year follow up. Our objective was to introduce lip repositioning as a successful treatment modality to decrease gingival show using a simple and conservative surgical approach.

Background and Aim: Nowadays, facial esthetics has become the main concern for many people. gummy smile (GS) is a common complaint that affects the esthetics and psychological status of patients. The aim of this study was to review GS treatment options. Materials and Methods: An electronic search was conducted in three databases of PubMed, Wiley and Cochrane Library from January 2015 up to August 2021. According to the eligibility criteria, a total of 41 relevant papers were retrieved and reviewed. Results: Based on the available data, several techniques have been reported for GS treatment, such as lip repositioning, crown lengthening, orthognathic surgery, laser application, botulinum toxin (BT) injection, hyaluronic acid injection, and micro autologous fat transplantation (MAFT). Combination of two or three of these techniques may yield a better result. Conclusion: A wide variety of procedures are available based on the cause of GS. The new, less invasive, faster and safer alternative techniques were shown to be feasible with a long-lasting result and minimal postoperative sequelae. Such treatment options for various types of GS can lead to significant improvement in smile esthetics with high patient satisfaction.

Background and Aim: Excessive display of gum tissue during smiling is called gummy smile. This situation is caused by several factors including altered passive eruption. The purpose of this investigation is to determine the correlation between gummy smile and altered passive eruption (APE) in a young population of women in Esfahan.Materials and Methods: In this cross sectional study, 842 females aged between 20 and 30 were examined in Esfahan.They were asked to smile in voluntary and involuntary (emotional) states. Gingival display (more than 1mm during smiling) as well as length of the clinical crowns (short or normal) in anterior teeth were recorded in a table. Statistical analysis of the data was carried out using chi square.Results: Results revealed that 223 subjects exhibited short clinical crowns and 619 had normal clinical crowns. gummy smile was reported in 128 subjects during voluntary state and in 556 subjects in involuntary state. 148 subject didn’t have gummy smile. Chi square analysis showed a correlation between short clinical crowns and the type of smile. In voluntary state, gummy smile was seen in 22.4% of the subjects with short clinical crowns and in 12.6% of the subjects with normal crown length (P< 0.001).Involuntary smiling resulted in gingival display in 68.6% of the subjects with short clinical crowns and in 66.7% with normal crown length (p=0.61).Conclusion: There is a correlation between altered passive eruption and gummy smile during involuntary (emotional) smiling.

The pursuit of esthetic excellence has become a major goal in the dental treatment and orthodontic treatment. The beauty of the smile is not only constituted by the shape, position, and size of the teeth, but also based on the characteristics of the gingival tissue and conformation of the lips, which should be as harmonious as teeth. gummy smile is one of the complaints of the patients, since such a situation can influence self-esteem and social relationships. The development of new more conservative techniques may provide a better therapeutic option than surgical proce-dures, such as the application of botulinum toxin, in the treatment of gummy smile. The purpose of this article is to present the case of a patient who presented den-togingival discrepancy and gummy smile, treated by resective gingival surgery and by application of botulinum toxin, optimizing smile harmony, and achieving im-proved self-esteem and quality of life. The application of botulinum toxin is an alternative less invasive, faster, safer, and more effective. Moreover, it produces harmonics and pleasing results when applied in target muscles, respecting the ap-propriate dose and type of smile. Therefore, the technique is a useful adjunct in the esthetic improvement of the smile and provides better results when combined with resective gingival surgery.