Evaluation of Different Periodontal Plastic Surgery Techniques for Gummy Smile Treatment

Study Overview
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Brief Summary
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Investigating different periodontal surgery techniques to treat gummy smile.

Detailed Description
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Participants will be subdivided into 3 (three) groups: Patients with upper lip hypermobility - surgery for device implantation in the anterior area of the maxilla; Patients with short teeth and upper lip hypermobility - flap surgery/gingivectomy and device implantation; and Patients who refuse implantation - flap surgery/gingivectomy;

Official Title
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Evaluation of Different Periodontal Plastic Surgery Techniques for Gummy Smile Treatment

Conditions
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Gummy Smile

Intervention / Treatment
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* Device: Peek device
* Other: Crown lengthening/gingivectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Gummy smile due to two etiologies (combined or isolated); Short clinical crown of teeth due to the altered passive eruption; Upper lip hyperactivity Exclusion Criteria: Smokers; Pregnant or breastfeeding patients; Patients with systemic diseases that can affect the result of surgical treatment (such as diabetes, heart diseases and taking blood anticoagulant medication, blood diseases, immunodeficiency disease etc.); Cleft lip; Craniofacial syndrome; Facial alteration surgeries during the study; Active orto treatment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Subjects with gummy smile and with upper lip hypermobility<br>Periodontal plastic surgery for peek device implantation with 4 screws in the anterior maxillary area | Device: Peek device<br>* Participants with gummy smile will be recruited from the Dental Clinic of Instituto Universitário Egas Moniz<br>|
| Experimental: Subjects with gummy smile and with short teeth and upper lip hypermobility<br>Gingivectomy/crown lengthening and device implantation in the anterior maxillary area. First crown lengthening procedure (CLP) will be performed creating a distance of 3mm between cementoenamel junction (CEJ). Next peek device will be position with 4 screws | Device: Peek device<br>* Participants with gummy smile will be recruited from the Dental Clinic of Instituto Universitário Egas Moniz<br>|
| Experimental: Patiens who refuse device implantation - control group<br>Gingivectomy/crown lengthening procedure | Other: Crown lengthening/gingivectomy<br>* Participante with gummy smile will be recruited from the Dental Clinic of Instituto Universitário Egas Moniz<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Superior incisors proportion (height x length) | Superior incisors height and lenght | Baseline and week 24 | 
| Change in Exposure of central incisors at rest | Measurement between incisal border of central incisors and the border of the lower lip during smile (in millimeters) | Baseline and week 24 | 
| Change in Periodontal probing | Three probes (mesial, buccal and distal) for exposed teeth during smile | Baseline and week 24 | 
| Change in Gengiva exposure at rest and forced smile | When lips are in rest position measure the amount of exposed gingiva and during a forced smile, make the same measure | Baseline and week 24 | 
| Change in Interlabial space at rest | When in rest position, measure distance between lips | Baseline and week 24 |