Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Panamericana Sur Km 19, Villa, Lima, Peru.
Department of Periodontology, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
Clin Oral Investig. 2022 Jun;26(6):4243-4261. doi: 10.1007/s00784-022-04467-0. Epub 2022 Mar 28.
To systematically review the literature regarding the clinical efficacy of reducing excessive gingival display (EGD) using the surgical lip repositioning technique (LRT) and its modifications. The question to address was: "What is the clinical efficacy of the surgical LRT and its modifications in patients with EGD?"
Four databases (MEDLINE-PubMed, Scopus, EMBASE, and CENTRAL) were searched up to December 2021 (PROSPERO-CRD42020205987). Randomized, non-randomized controlled and prospective case series with a minimum of 6-month follow-up were eligible for inclusion. Two meta-analyses were performed using the mean difference (MD) between baseline and different follow-up periods (6 and 12 months). Subgroup analyses were performed using the different modifications of LRT.
The electronic research retrieved 783 studies. Only 13 met the inclusion criteria and were included in the statistical analysis. Six modifications of the original LRT were identified. An overall EGD reduction of -3.06 mm (95%CI: -3.71-2.40), -2.91 mm; (95%CI: -3.66-2.15) and -2.76 mm; (95%CI: -3.83--1.70) was achieved after 6, 12, and 36 months, respectively, compared to baseline (P < 0.01). Meta-analysis revealed that the use of LRT with periosteal suturing showed the greatest decrease in EGD with 5.22 mm (95% CI: 4.23-6.21; P < 0.01) at 6 months and 4.94 mm (95% CI: 3.86-6.02; P < 0.01) at 12 months.
Both the original LRT and its different modifications reduce EGD and provide good results and overall patient satisfaction at 6, 12, and 36 months of follow-up.
Evaluating the different modifications of the LRT can be a guiding aspect for the clinical and surgical approach to be used in patients with EGD.
系统回顾有关使用外科唇复位术（LRT）及其改良术减少过度牙龈显露（EGD）的临床疗效的文献。要解决的问题是：“外科 LRT 及其改良术在 EGD 患者中的临床疗效如何？”
检索了 4 个数据库（MEDLINE-PubMed、Scopus、EMBASE 和 CENTRAL），检索时间截至 2021 年 12 月（PROSPERO-CRD42020205987）。符合纳入标准的研究为至少 6 个月随访的随机、非随机对照和前瞻性病例系列研究。使用基线和不同随访时间（6 个月和 12 个月）之间的平均差值（MD）进行了 2 项荟萃分析。使用 LRT 的不同改良术进行了亚组分析。
电子检索共检索到 783 项研究，仅有 13 项符合纳入标准并纳入了统计学分析。确定了 LRT 的 6 种改良术。与基线相比，术后 6、12 和 36 个月时，EGD 分别平均减少了-3.06 毫米（95%CI：-3.71-2.40）、-2.91 毫米（95%CI：-3.66-2.15）和-2.76 毫米（95%CI：-3.83--1.70）（P < 0.01）。荟萃分析显示，使用骨膜缝合的 LRT 可使 EGD 减少 5.22 毫米（95%CI：4.23-6.21；P < 0.01），在 6 个月时，使用骨膜缝合的 LRT 可使 EGD 减少 4.94 毫米（95%CI：3.86-6.02；P < 0.01），在 12 个月时。
原始 LRT 及其不同改良术均可减少 EGD，并在 6、12 和 36 个月的随访中提供良好的效果和总体患者满意度。
评估 LRT 的不同改良术可以为 EGD 患者的临床和手术方法提供指导。
