Managing Excessive Gum Display Caused By Hyperactive Lip Movement with Coronally Placed Vestibulum

Authors

  • Michael Christian Tjandrawinata Universitas Airlangga
  • Vinanto Putera Universitas Airlangga
  • Agung Krismariono Universitas Airlangga
  • Irma Josefina Savitri Universitas Airlangga

DOI:

https://doi.org/10.55606/jpikes.v6i1.6716

Keywords:

Esthetic Dentistry, Excessive Gingival Display, Coronally Placed Vestibulum, Gummy Smile, Hypermobile Upper Lip

Abstract

An excessive gum display (EGD) refers to a smile that displays more than 2 mm of visible gingiva. Among dental patients, it is a prevalent aesthetic issue. It influences both psychological and aesthetic status since it typically lowers self-confidence. EGD is considered unaesthetic when smiling, thus many patients seek treatment to manage this condition. The etiology of EGD varies, with hypermobile upper lip (HUL) as the most predominant. HUL is defined as more than 8 mm of upper lip movement from rest to maximum smile. This article will discuss about the management of EGD caused by HUL, treated with coronally placed vestibulum. Case: A 28-year-old male patient came with a complaint of disproportionate gingival display. The patient felt that his gums were exposed too much when smiling. The patient was not confident with the condition. On maximum smile, 6 mm of gingiva was displayed due to hypermobile upper lip. The diagnose of excessive gum display was established. The treatment was coronally placed vestibulum, which done by relocating the attachment between the mucosa and the attached gingiva closer to the coronal. Follow-up results after 3 months showed a noticeable decrease in excessive gingival display. Discussion: Coronally placed vestibulum is performed on cases of EGD with the etiology of HUL. Through this procedure, the vestibule's limiting muscular pull is narrowed, reducing gingival display when smiling. Conclusion: Coronally placed vestibulum is a less-invasive treatment of choice for EGD caused by HUL.

Downloads

Download data is not yet available.

References

Brizuela, M., & Ines, D. (2023, March 19). Excessive gingival display. In StatPearls [Internet]. StatPearls Publishing. https://www.statpearls.com

Dym, H., & Pierre, R., 2nd. (2020). Diagnosis and treatment approaches to a "gummy smile." Dental Clinics of North America, 64(2), 341–349. https://doi.org/10.1016/j.cden.2020.01.007

Venugopal, A., Manzano, P., Ahmed, F., Vaid, N. R., & Bowman, S. J. (2024). Gummy smiles: Etiologies, diagnoses & formulating a clinically effective treatment protocol. Seminars in Orthodontics. https://doi.org/10.1053/j.sodo.2024.03.001

Maleki, M., Huang, B., Mendes, V. C., Caminiti, M. F., & Finer, Y. (2024). A systematic review and meta-analysis comparing surgical and nonsurgical treatments for excessive gingival display. Dentistry Journal, 12(6), 154. https://doi.org/10.3390/dj12060154

Hung, Y., Lin, I., Wang, S., & Lai, E. H. (2020). A stepwise approach to the correction of excessive gingival display: An integrative review of the literature. Australasian Orthodontic Journal, 36, 184–194. https://doi.org/10.1002/aoj.122

Tatakis, D. N., & Silva, C. O. (2023). Contemporary treatment techniques for excessive gingival display caused by altered passive eruption or lip hypermobility. Journal of Dentistry, 138, 104711. https://doi.org/10.1016/j.jdent.2023.104711

Shivaprasad, B., Geetha, K., Sameera, U., & Paunami, P. (2019). Lip repositioning with myotomy - A surgical approach to treat gummy smile. Journal of Evolution of Medical and Dental Sciences, 8, 2526–2529. https://doi.org/10.14260/jemds/2019/559

Bouguezzi, A., Boudour, O. H., Sioud, S., Hentati, H., & Selmi, J. (2020). Mucosal coronally positioned flap technique for management of excessive gingival display. The Pan African Medical Journal, 36, 235. https://doi.org/10.11604/pamj.2020.36.235.19845

Handayani, D. M. P., Nursolihati, V., & Hafiyyah, O. A. (2024). Lip repositioning with internal suturing and crown lengthening in a single visit: Case report. Interdental Jurnal Kedokteran Gigi (IJKG), 20(2), 335–343. https://doi.org/10.1016/j.ijkg.2024.03.014

Krismariono, A. (2018). Coronally positioned vestibule for gummy smile. Journal of International Dental and Medical Research, 11, 707–710.

Tatakis, D. N. (2022). Lip repositioning techniques and modifications. Dental Clinics of North America, 66(3), 373–384. https://doi.org/10.1016/j.cden.2022.04.004

Sarfi, D., Bouzoubaa, S. M., & Yahya, I. (2022). Lip repositioning technique: A simple surgical procedure to improve the harmony and symmetry of the smile: A case report. Advances in Oral and Maxillofacial Surgery, 6, 100260. https://doi.org/10.1016/j.aoms.2022.100260

Foudah, M. A. (2019). Lip repositioning: An alternative to invasive surgery: A 4-year follow-up case report. The Saudi Dental Journal, 31(Suppl), S78–S84. https://doi.org/10.1016/j.sdent.2019.03.002

Salihu, B., Agani, Z., & Demiri, A. S. (2024). Lip repositioning surgery: A simple smile and life transformation procedure. Case Reports in Dentistry, 2024, 6156806. https://doi.org/10.1155/2024/6156806

Downloads

Published

2026-01-29

How to Cite

Michael Christian Tjandrawinata, Vinanto Putera, Agung Krismariono, & Irma Josefina Savitri. (2026). Managing Excessive Gum Display Caused By Hyperactive Lip Movement with Coronally Placed Vestibulum. Jurnal Pengabdian Ilmu Kesehatan, 6(1), 150–156. https://doi.org/10.55606/jpikes.v6i1.6716

Similar Articles

You may also start an advanced similarity search for this article.