DUDAĞIN YENIDEN KONUMLANDIRILMASI VE GINGIVEKTOMI YAPILARAK GUMMY SMILE TEDAVISI BIR OLGU SUNUMU (GUMMY SMILE)

Abstract

ÖZET

Dişetinin aşırı derecede görünmesinin etiyolojilerine bağlı olarak değişik tedavi yöntemleri vardır. Bu vaka raporunda aşırı dişeti görünmesinin gingivektomi ve dudağın yeniden konumlandırılması birlikte uygulanarak yapılan tedavinin yöntemi gösterilmektedir.26 yaşında gülerken aşırı derecede görünen dişetinden şikayetçi olan bayan hastaya lokal anestezi altında bu teknik uygulandı. Tekniğin temel amacı elevatör kasların retraksiyonunu sınırlayarak gummy smile´ı azaltmaktır. Bu teknik, maksiller vestibül bölgedeki mukogingival birleşimden üst dudak bölgesindeki vestibül sulkusa kadar mevcut olan mukozanın yarım kalınlık flep ile bant şeklinde soyulup, üst dudağın mukogingival birleşimine dikilerek yapılmaktadır. Sonuç olarak sığ vestibül sulkus oluşur ve kasların çekme kuvveti azalır buna bağlı olarak da görünen diş eti miktarı azalır.

Keywords

• gingivektomi, dudağın yeniden konumlandırılması, mukogingival birleşim

TREATMENT GUMMY SMILE WITH A LIP REPOSITIONING TECHNIQUE AND GINGIVECTOMY A CASE REPORT

Abstract

Excessive gingival display can be managed by variety of treatment modalities, depending on specific diagnosis. This case report demonstrates the successful management of excessive gingival display with a lip-repositioning and gingivectomy. A female patient aged 26 years reported with a chief complaint of gummy smile and was treated with this technique performed under local anesthesia with the main objective to reduce gummy smile by limiting the retraction of elevator muscles (e.g., zygomaticus minor, levator anguli, orbicularis oris, and levator labii superioris). The technique is fulfilled by removing a strip of mucosa from maxillary vestibule and creating a partial thickness flap between mucogingival junction and upperlip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display

Keywords

• Gummy smile, gingivectomy, lip repositioning, mucogingival junction

References

1. Büyükkaplan U Ş, Ğüldağ M Ü, Şentut F, Köseler Şentut T. Maksiller Keserlerin Gingival Tepe Noktaları pozisyonlarının incelenmesi: Bir Pilot çalışma. Atatürk Üniv Diş Hek Fak Derg 2011;3:165-9
2. Crispin BJ, Watson JF. Margin placement of esthetic veneer crowns. Part I: Anterior tooth visibility. J Prosthet Dent 1981;45:278-82.
3. Allen EP. Use of mucogingival surgical procedures to enhance esthetics. Dent Clin North Am 1988;32:307-30.
4. Silberberg, N., Goldstein, M. & Smidt, A. Excessive gingival display–etiology, diagnosis,and treatment modalities. Quintessence International 2009; 40:809–18.
5. Gargruilo A, Wenz F, Orban B. Dimensions and relations at the dentogingival junction in humans. J Periodontal 1961;132:261-7.
6. Maynard JG Jr, Wilson RD. Physiologic dimensions of the periodontium significant to the restorative dentist. J periodontal 1979;50:170-4.
7. Lee EA. Aesthetic crown lengthening: classification, biologic rationale, and treatment planning considerations. Pract Proced Aesthet Dent. 2004; 16:769-78.
8. Chu SJ, Karabin S, Mistry S. Short tooth syndrome: diagnosis, etiology, and treatment management. J Calif Dent Assoc. 2004;32:143-52.

9. Ezquerra F, Berrazueta MJ, Ruiz-Capillas A, Arregui JS. New approach to the gummy smile. Plast Reconstr Surg. 104:1143-1150;discussion. 1999; 1151-2.
10. Sarosh F, Dastoor, Carl E. Missch, Hom-Lay Wang. Botulinum Toxin To Enhance Facial Macroesthetics: A Literature Review Journal Of Oral Implantology 2007;33;164-71
11. Krishna Kumar Gupta, Amitabh Srivastava, Rameshwari Singhal, Sumedha Srivastava An innovative repositioning, Journal of Indian Society of Periodontology 2010;14:266-9. called lip
12. Friedman N. Mucogingival surgery. The apically repositioned flap. Journal of Periodontology 1962;33:328-40.
13. Rubinstein A, Kostianovsky A. Cosmetic surgery fort he malformation of the laugh: Original technique. Prensa Med Argent 1973:60:952-4
14. A. H. L. Tjan, G. D. Miller, and J. G. P. The, “Some esthetic factors in a smile,” The Journal of Prosthetic Dentistry, vol. 51,no. 1, pp. 24–28, 1984
15. Miskinyar, S. A. A new method for correcting a gummy smile. Plastic and Reconstrutive Surgery 1983;72:397–400.
16. Rubinstein AM, Kostianovsky AS. Cirugia estetica de la malformaciaon de la sonrisa Pern Med Argent. 1973;60:952.
17. Rosenblatt A, Simon Z. Lip Repositioning for Reduction of Excessive Gingival Display: AClinical Report. Int J Perio Rest Dent 2006;26:433-7.
18. .Ziv Simon, D.M.D., M.Sc., Ari Rosenblatt, D.D.S., D.M.D., William Dorfman, D.D.S., F.A.A.C.D. Eliminating a Gummy Smile with Surgical Lip Repositioning, The Journal of Cosmetic Dentistry 2007; 23:1-102
19. Kamer F. “How do I do it”—Plastic surgery, practical suggestions on facial plastic surgery, smile surgery. Laryngoscope 1979;89:1528- 32,
20. Silva CO, Ribeiro-Junior NV, Campos TVS, Rodrigues JG, Tatakis DN. Excessive gingival display: treatment by a modified lip repositioning technique. J Clin Periodontol 2013; 40: 260-5.
21. Cachay-Velasquez H. Rhinoplasty and facial expression. Ann Plast Surg 1992;28:427433.
22. Litton C, Fournier P. Simple surgical correction of the gummy smile. Plast Reconstr Surg1984; 63:372-3.