Al Jasser Reham, AlSaif Rand, AlSohaim Loulwah, Baidas Raghad, AlOtibi Faiza Al, Andijani Reem
Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
Saudi Board of Periodontics, King Saud University, Saudi Arabia.
Saudi Dent J. 2024 Aug;36(8):1135-1140. doi: 10.1016/j.sdentj.2024.06.012. Epub 2024 Jun 8.
Excessive gingival display (EGD) is a mucogingival deformity characterized by overexposure of the maxillary gingiva while smiling. This cross-sectional study aimed to identify EGD etiologies and their prevalence in participants at King Saud University, Saudi Arabia.
Adults with a gummy smile, who resided in Saudi Arabia, were nonsmokers, had good overall health, and had all their maxillary anterior teeth were eligible for inclusion. Participants were first screened by phone, and those who met the eligibility criteria were further screened at the Dental University Hospital (King Saud University, Riyadh, Saudi Arabia). The demographic characteristics of all eligible participants were recorded. Participants were further subjected to extraoral examination, which included gingival display (GD), vertical maxillary excess (VME), hypermobile upper lip (HUL), smile line, altered passive eruption (APE), gingival overgrowth, and short upper lip (SUL). Intraoral examination included periodontal pocket depth and bleeding upon probing. Student's -test was used to compare the mean GD values across the main etiologies (VME, HUL, APE, and SUL).
All 123 participants (mean age: 23.1 ± 0.2 years; 74 females) had EGD (i.e., GD ≥ 4 mm), of whom 55 (44.7 %) had a single etiology, and the remaining 68 (55.3 %) had > 1 etiology. APE was the predominant etiology (n = 90, 73.2 %) in the study population. Of these (n = 90), APE alone was prevalent in 29 (32.2 %) participants, whereas the remaining patients had APE in combination with other EGD etiologies (n = 61; 67.8 %). The presence of more than one EGD etiology in the same participant was associated with greater GD. The VME and HUL were significantly associated with smile line classes (p < 0.05).
APE (alone or in combination) was the predominant etiology of EGD in the study population. The presence of multiple EGD etiologies in the same patient emphasizes the need for an etiology-based, sequential, and multiple-treatment strategy to effectively manage EGD.
牙龈过度外露（EGD）是一种黏膜牙龈畸形，其特征为微笑时上颌牙龈过度暴露。这项横断面研究旨在确定沙特阿拉伯国王沙特大学参与者中EGD的病因及其患病率。
居住在沙特阿拉伯、不吸烟、总体健康状况良好且上颌前牙完整的成年露龈笑患者符合纳入标准。参与者首先通过电话进行筛查，符合入选标准的患者在牙科大学医院（沙特阿拉伯利雅得国王沙特大学）进一步筛查。记录所有符合条件参与者的人口统计学特征。对参与者进一步进行口外检查，包括牙龈外露（GD）、垂直上颌骨过长（VME）、上唇活动过度（HUL）、微笑线、被动萌出改变（APE）、牙龈增生和上唇过短（SUL）。口内检查包括牙周袋深度和探诊出血。采用学生t检验比较主要病因（VME、HUL、APE和SUL）的平均GD值。
所有123名参与者（平均年龄：23.1±0.2岁；74名女性）均有EGD（即GD≥4mm），其中55名（44.7%）有单一病因，其余68名（55.3%）有多种病因。APE是研究人群中的主要病因（n=90，73.2%）。在这90名患者中，单纯APE在29名（32.2%）参与者中常见，而其余患者的APE与其他EGD病因并存（n=61；67.8%）。同一参与者存在多种EGD病因与更大的GD相关。VME和HUL与微笑线类别显著相关（p<0.05）。
APE（单独或合并其他病因）是研究人群中EGD的主要病因。同一患者存在多种EGD病因强调了需要一种基于病因的、序贯的和多种治疗策略来有效管理EGD。
