Clinical trial NCT06944535: Efficacy of a Modified Lip Repositioning Surgery Technique With Tie Levator Labii Superioris and Without Frenectomy and Myotomy for Treatment of Excessive Gingival Display
Official title: Efficacy of a Modified Lip Repositioning Surgery Technique With Tie Levator Labii Superioris and Without Frenectomy and Myotomy for Treatment of Excessive Gingival Display: a Pre-post Clinical Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Excessive Gingival Display
Keywords: Excessive gingival display
gummy smile
ip repositioning surgery
Lead sponsor: Can Tho University of Medicine and Pharmacy
Sponsor class: OTHER
First posted: 2025-04-25
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: OTHER

Brief summary: The objective of this prospective study was to investigate a modified lip repositioning surgery technique with tie labii superioris and without frenectomy and myotomy for the treatment of excessive gingival display

Detailed description: Excessive gingival display (EGD), commonly referred to as a "gummy smile" (GS), is one of the most common deformities and conditions of the gingival mucosa around teeth and can be a significant aesthetic concern for some individuals, leading them to seek treatment. The presence of EGD/GS has a negative impact on the patient's oral health-related quality of life, including aspects of functional limitation, psychological distress, psychological disability, and social disability. Successful treatment of Excessive gingival display with the lip repositioning surgery (LRS) has been reported in the literature. The last few years have seen the introduction of new techniques for altered passive eruption (APE) and hypermobile upper lip (HUL)management, an expansion of the available aesthetic crown lengthening (ACL) and LRS variations, and additional evidence further supporting the effectiveness of these two procedures. Several of the recently introduced approaches offer unique, innovative, and potentially impactful concepts. However, for many of these newly described treatments the available evidence is limited to case reports and the exact indications remain to be adequately defined. The literature lacks adequate clinical trials of LRS with sufficient follow-up time. Nevertheless, in regards to gingival display GD reduction, a recent systematic review found a mean reduction of 3.4 mm with a median follow-up time of 6 months. Some research found significant increase in upper lip length and upper lip vermilion length 6-months post-operative PO. Moreover, some case reports of LRS mentioned fuller upper lip appearance after treatment. Excessive gingival display, or "gummy smile", can be successfully managed through various surgical approaches that must be chosen based on the underlying etiology and clinical characteristics of each case. Therefore, this study aimed to explore the efficacy outcomes of a lip repositioning technique for the treatment of excessive gingival display

Eligibility criteria: Inclusion Criteria:

* Adults (\>18 years old)
* Systemically healthy
* No medication intake
* Nonsmoker
* Periodontally healthy
* Maxillary anterior teeth of normal dimensions
* Normal upper lip length (females: 20-22 mm; males: 22-24 mm) hyperactive upper lip (lip mobility \>8 mm) and gingival display \> 4mm during smile

Exclusion Criteria:

The patient has trauma and facial deformities

Primary outcomes:
measure: The objective of this prospective study was to investigate outcomes of a lip repositioning technique for the treatment of excessive gingival display
timeFrame: The following parameters were assessed from clinical photographs obtained during active smile, with a mm ruler in place, and were recorded at baseline, 3 and 6 months
Secondary outcomes:
Other outcomes:
Locations:
city: Cần Thơ
country: Vietnam
facility: Can Tho University of Medicine and Pharmacy
Study officials:
affiliation: Can Tho University of Medicine and Pharmacy
name: Lam N Le, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Tawfik OK, El-Nahass HE, Shipman P, Looney SW, Cutler CW, Brunner M. Lip repositioning for the treatment of excess gingival display: A systematic review. J Esthet Restor Dent. 2018 Mar;30(2):101-112. doi: 10.1111/jerd.12352. Epub 2017 Nov 27.