Title: Lip repositioning surgery as an adjunctive esthetic approach in periodontal and implant therapy
Abstract:
Background: Excessive gingival display (EGD), commonly referred to as a gummy smile, is a frequent esthetic concern that may negatively affect patient satisfaction, particularly in the anterior maxilla. In periodontal and implant therapy, achieving optimal soft tissue esthetics is essential for harmonious and predictable smile outcomes. Lip repositioning surgery has emerged as a minimally invasive approach designed to reduce gingival exposure by limiting the superior movement of the upper lip during smiling.
Objective: The objective of this presentation is to evaluate the role of lip repositioning surgery as an adjunctive esthetic procedure in periodontal and implant treatment planning, with emphasis on patient selection, surgical technique, and clinical outcomes.
Methods: Lip repositioning surgery involves the excision of a strip of mucosa from the maxillary labial vestibule followed by suturing the lip in a more coronal position, thereby reducing gingival display. This technique may be performed as a standalone procedure or in combination with periodontal therapies such as crown lengthening, as well as during implant placement or prosthetic rehabilitation in the esthetic zone. Accurate diagnosis of the etiology of EGD—including hypermobile upper lip, altered passive eruption, and dentoalveolar discrepancies—is critical for achieving predictable and stable results.
Results: Clinical studies and documented case reports demonstrate a significant reduction in gingival display following lip repositioning surgery, accompanied by high levels of patient satisfaction. When combined with periodontal and implant procedures, lip repositioning contributes to enhanced smile harmony, improved soft tissue symmetry, and more predictable esthetic outcomes. Although relapse has been reported in some cases, careful patient selection and modified surgical techniques have shown improved long-term stability.
Conclusion: Lip repositioning surgery represents a valuable adjunctive technique in periodontal plastic surgery and esthetic implant dentistry. When incorporated into comprehensive treatment planning, it offers a conservative and effective solution for managing excessive gingival display and optimizing esthetic results in the anterior maxilla.
