THE EIGHT CAUSES OF GUMMY SMILE OR EXCESSIVE GINGIVAL DISPLAY :
- Short upper lip (if a patient has an extremely short upper lip it’s not going to cover gingiva and their upper teeth)
- Hypermobile lip (lip moves too much)
- Vertical maxillary excess (VME) (short ramus and overgrowth of maxilla)
- Anterior over-eruption (excess overbite)
- Wear and compensatory eruption
- Altered active eruption (the teeth don’t make it out of bone)
- Altered passive eruption (gingiva doesn’t recede as the person matures)
- Combination of above
MANAGEMENT OF GUMMY SMILE:
A. Traditional methods
1.Orthodontics intrudes over erupted teeth levelling them to their correct position.
2.Periodontal surgery (Crown lengthening) in cases of short teeth.
3.Orthognathic surgery (Le Fort Type 1 Maxillary Intrusion Osteotomy) treats gummy smile by moving the maxilla in an apical direction impacting the maxilla.
A bimaxillary Orthognathic Surgery to impact the maxilla, that is, to reposition it upwards and eliminate excess gums. Normally this type of patients will also receive orthodontic treatment.
B. Non Traditional Methods
1. Lip Repositioning Surgery
2. BOTOX