A Modified Approach in Lip Repositioning Surgery for Excessive Gingival Display to Minimize Post-Surgical Relapse: A Randomized Controlled Clinical Trial.

Lip repositioning surgeries are performed to treat patients with excessive GD (EGD). This study aimed to explore and compare the long-term clinical results and stability following the modified lip repositioning surgical technique (MLRS) with the addition of periosteal sutures compared to the conventional lip repositioning surgery (LipStaT) in order to address EGD. A controlled clinical trial with female participants ( = 200) intended to improve their gummy smile were divided into control ( = 100) and test ( = 100) groups. The gingival display (GD), maxillary lip length at rest (MLLR), and maxillary lip length at maximum smile (MLLS) were measured at four time intervals (Baseline; 1 Month; 6 Months, and 1 Year) in millimeters (mm). Data were analyzed by -tests, Bonferroni-test, and regression analysis using SPSS software. At the one-year follow-up, GD for the control and test groups were 3.77 + 1.76 mm and 2.48 + 0.86 mm, respectively, and their comparisons showed that GD was considerably lower ( = 0.000) in the test group compared to the control group. The MLLS measurements taken at baseline, one-month, six-month, and one-year follow-up showed no significant differences ( > 0.05) between the control and test groups. At baseline, one-month, and six-month follow-up, the mean and standard deviation for the MLLR were almost similar, with no statistically significant difference ( = 0.675). The MLRS is a successful and viable treatment option for the treatment of patients with EGD. The current study showed stable results and no recurrence with MLRS until the one-year follow-up compared to LipStaT. With the MLRS, a 2 to 3 mm decline in EGD is usually to be expected.