治疗粘笑结合冠延长，嘴唇重新定位，并使用聚酯线

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Advances in Periodontics Pub Date : 2022-06-25 DOI:10.1002/cap.10214

Renata O. R. Horn, Júlio C. Joly

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引用次数: 2

摘要

该病例报告提出了一种新的治疗粘笑的可能性，患者有多种病因，如改变被动爆发和上唇过度活动。起初，冠延长不足以达到预期的美学效果，需要与唇部复位相结合。病例介绍冠延长手术(CLS)是一名20岁的女性，她的牙龈显示为7.5 mm，使她的牙龈暴露减少到5.5 mm。由于患者在6个月后仍不满意，我们采用了新的手术方式。为了进一步减少她的牙龈暴露，我们进行了唇复位技术，同时进行了肌切开术和插入聚酯线作为物理屏障，以防止复发。结论采用冠延长+唇复位两种技术组合后，龈面显示缩小至2.5 mm，消除了粘牙现象。为什么这个案例是新信息?结合唇部复位和肌切开术技术，插入聚酯线作为防止复发的物理屏障。成功管理这个案例的关键是什么?正确的病因诊断。事先应用肉毒杆菌毒素。尊重1个月的聚酯线插入期，有助于保存缝线(限制活动)。在这种情况下，成功的主要限制是什么?让患者注意不要用手移动嘴唇，以便观察切口。

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Treatment of gummy smile combining crown lengthening, lip repositioning, and the use of polyester threads

Introduction

The case report presents a new possibility of treatment for a gummy smile in a patient with multiple etiologies, such as altered passive eruption and hypermobility upper lip. At first, crown lengthening was not sufficient to achieve the desired aesthetic result, being necessary its combination with lip repositioning.

Case Presentation

Crown lengthening surgery (CLS) was performed in a 20-year-old woman, with a gingival display of 7.5 mm, having her gingival exposure reduced to 5.5 mm. Because the patient continued unsatisfied after 6 months, a new procedure was adopted. To reduce even more her gingival exposure, lip repositioning technique was performed associated with myotomy and the insertion of polyester threads as a physical barrier to prevent relapse.

Conclusion

The result of the gingival display was reduced to 2.5 mm, removing the condition of a gummy smile after the combination of both techniques: crown lengthening, and lip repositioning.

Key points

Why is this case new information?

Association of the technique of lip repositioning and myotomy, the insertion of polyester threads that act as a physical barrier against recurrence.

What are the keys to successful management of this case?

Correct etiological diagnosis.
Prior application of botulinum toxin.
Respect the period of 1 month for the insertion of the polyester thread, helping to preserve the suture (limitation of movement).

What are the primary limitations to success in this case?