Alkari Sara, Hamadah Omar, Parker Steven
Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
De Montfort University, Leicester, UK.
Maxillofac Plast Reconstr Surg. 2025 Aug 14;47(1):20. doi: 10.1186/s40902-025-00475-8.
Excessive gingival display is a common and often distressing aesthetic concern among patients. With the increasing emphasis on dental aesthetics, it has become essential to investigate and develop various treatment modalities to address patients' expectations. Achieving a balanced and attractive smile has therefore become a key challenge for dental practitioners worldwide.
This study is a single-center, parallel, randomized controlled open-label trial aimed to compare performing lip repositioning surgery (LRS) utilizing carbon dioxide (CO₂) laser with conventional scalpel in managing excessive gingival display (EGD) (4-6 mm) with special consideration to lip dimensions, and 20 participants were included in this study setting in the Faculty of Dentistry, 70% females and 30% males, with an average age of 26.4 and 24.8 years in laser and scalpel groups, respectively, randomly allocated into two groups. All patients fulfilled the study. A partial thickness flap was excised from the vestibule, with both edges of the donor wound closed using sutures; clinical measurements were recorded preoperatively and followed up for 6 months.
Postoperative pain was significantly reduced in the laser group; both groups demonstrated a significant decrease in gingival display at 6-month post-operation: external upper lip length was significantly longer in the laser group in smile position at 1-month post-operation, and internal upper lip length at rest was significantly longer in the scalpel group at 3-month post-surgery (significance level was set at P < 0.05).
The CO₂ laser is an effective, safe, and conservative alternative to the scalpel in performing LRS, offering decreased pain and improved visualization. Adequate training in laser techniques and safety is essential.
The study is registered at International Standard Randomized Controlled Trial, registration number ISRCTN.
牙龈过度外露是患者中常见且常令人苦恼的美学问题。随着对牙齿美学的日益重视，研究和开发各种治疗方法以满足患者期望变得至关重要。因此，实现平衡且有吸引力的笑容已成为全球牙科从业者面临的关键挑战。
本研究是一项单中心、平行、随机对照开放标签试验，旨在比较使用二氧化碳（CO₂）激光进行唇部复位手术（LRS）与传统手术刀治疗牙龈过度外露（EGD）（4 - 6毫米），特别考虑唇部尺寸。本研究在牙科学院纳入了20名参与者，其中70%为女性，30%为男性，激光组和手术刀组的平均年龄分别为26.4岁和24.8岁，随机分为两组。所有患者均完成研究。从前庭切除部分厚度的皮瓣，供体伤口的两边用缝线缝合；术前记录临床测量数据，并随访6个月。
激光组术后疼痛明显减轻；两组在术后6个月牙龈外露均显著减少：术后1个月微笑位时激光组的外部上唇长度显著更长，术后3个月手术刀组静止时的内部上唇长度显著更长（显著性水平设定为P < 0.05）。
在进行唇部复位手术时，CO₂激光是一种有效、安全且保守的替代手术刀的方法，可减轻疼痛并改善视野。对激光技术和安全进行充分培训至关重要。
该研究在国际标准随机对照试验注册，注册号为ISRCTN。
