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Lip Repositioning with Myotomy- A Surgical Approach to Treat Gummy Smile

Excessive gingival display also referred as “gummy smile” is one of the major concerns with regard to appearance for many people in this generation. According to Peck et al, an exposure of more than 2 mm of gingiva during smiling is defined as gummy smile. 1 Most of the patients complain of unaesthetic appearance due to excessive gingival display during communication and smiling. Gingival display of ≥ 4 mm is considered unattractive by both professionals and lay people. 2,3 This may have a negative influence on one's oral health related quality of life and also can lead to psychological discomfort. 4 A pleasant smile requires harmony among size, shape, colour of the teeth, gingival health and also an appropriate amount of gingival display during smiling. 5 An imaginary line following the lower margin of the upper lip during smiling is the smile line. 6 According to the degree of exposure of teeth and gums, Goldstein classified smile line into 3 types: High, medium, or low gummy smiles (GSs) ranged from mild, moderate, and advanced, to severe. 7 The display of entire cervico-incisal length of the maxillary incisors and more than 3 mm of gingiva is the characteristics of a high smile line. When only part of teeth is visible during smiling the smile, line is considered as low and in a medium smile line,