Horn Renata Oliveira Ribeiro, Elias Carlos Nelson, Joly Júlio César
São Leopoldo Mandic University, Campinas, SP, Brazil.
Instituto Militar de Engenharia, Rio de Janeiro, RJ, Brazil.
Int J Dent. 2022 Oct 15;2022:3972150. doi: 10.1155/2022/3972150. eCollection 2022.
A new technique is proposed in this study to correct the gummy smile (GS) with myotomy, combining lip repositioning with the insertion of polyester threads at the surgical site to act as a physical barrier and control relapse. 11 patients were clinically assessed (30.2 ± 7.43 years old, 90.9% females and 9.10% males). All patients presented gingival display (GD) greater than 4 mm. Hypermobile upper lip (HUL), vertical maxillary excess (VME) + HUL, altered passive eruption (APE) + HUL, and VME + APE were the etiologies identified. Three polyester threads were inserted in each patient one month after the surgery. The GS was measured before, 6 months, and 12 months after the surgery. The results showed a reduction in the mean GD of the patients, 4.42 mm after 6 months ( value = 0.000) and 4.13 mm after 12 months ( value = 0.000). The largest relapse was 0.29 mm and was not statistically significant ( value = 0.07). The Friedman test with pairwise comparisons was used to determine the existence of statistically significant differences in GD between the periods analyzed. The results showed that the proposed technique was successful in treating GS, presenting significant reductions in the GD 12 months after surgery and controlling the relapse.
本研究提出了一种新技术,通过肌切开术矫正露龈笑(GS),将唇部重新定位与在手术部位插入聚酯线相结合,以起到物理屏障的作用并控制复发。对11例患者进行了临床评估(年龄30.2±7.43岁,女性占90.9%,男性占9.10%)。所有患者的牙龈暴露(GD)均大于4mm。确定的病因包括上唇过度活动(HUL)、上颌垂直过长(VME)+HUL、被动萌出改变(APE)+HUL以及VME+APE。术后1个月,为每位患者插入三根聚酯线。在手术前、术后6个月和12个月测量露龈笑情况。结果显示,患者的平均GD有所降低,术后6个月时为4.42mm(P值=0.000),术后12个月时为4.13mm(P值=0.000)。最大复发量为0.29mm,无统计学意义(P值=0.07)。采用Friedman检验及两两比较来确定所分析时间段内GD是否存在统计学显著差异。结果表明,所提出的技术成功治疗了露龈笑,术后12个月时GD显著降低且复发得到了控制。