ABSTRACT
The aim of this case report was to evaluate the clinical outcomes following modified lip repositioning and gingivectomy along with depigmentation in a patient with excessive gingival display. A 22 year old female patient came with the chief complaint of gummy smile and blackened gums. On evaluation, the patient presented with hyperactive lip and moderate vertical maxillary excess. Aless invasive modified lip repositioning procedure was carried out. A partial thickness strip of mucosa was removed leaving the midline frenum intact and the lip mucosa was sutured to the mucogingival line. As the clinical crown length was shorter than the anatomic crown length, crown lengthening by gingivectomy was performed. Laser depigmentation was carried out to treat gingival hyperpigmentation. The patient was evaluated after 2 weeks, 1 and 6 months respectively. An approximate reduction in gingival display of around 3 mm was found and the results were stable at the end of 6 months. Gingival repigmentation had occurred at the end of 6 months, therefore depigmentation procedure was repeated inorder to the maintain the esthetics. In this case, we emphasize on the stable and satisfactory treatment outcome of a non invasive approach made to treat excessive gingival display instead of more invasive surgical treatment.
ABSTRACT
Since Wilmar first described term "Long face", various methods have been performed to enhance features of the patients with vertical excess of face, but Kawamoto established that the sole method to correct these deformities is to shorten the height of maxilla by LeFort I osteotomy. Features of the lower long facial pattern, conveniently called "Long face syndrome", "Horse face" has following characteristics; 1) Disproportionally elingated lower half of the face. 2) Widely separated lip and visible anterior teeth. 3) Hyperactivity of mentalis muscle. 4) The smile is typically "Gummy" 5)On profile, convex dorsum of nose, and receded double bump appearance of chin. 6) Tendency of class II malocclusion. From May, 1994 to April, 1999 we have treated 6 cases of vertical maxillary excess, "Long face syndrome" patient using maxillary LeFort I osteotomy and ancillary mandibular surgery. Sometimes there were combined bimaxillary prognathi and hemifacial hypertrophies. Age varied from 22 to 31(mean 23) and follow-up period varied from 6 months to 3 years(mean 1 year). Vertical shortening, rotation of the maxilla and combined mandibular adjustment surgery resulted in good facial harmony improvement of characteristics above and satisfaction of the patient with long face syndrome.