Modified Lip Repositioning Surgery with and without Dual-layered Suturing for Treatment of Gummy Smile Patients.

Background: The present study was performed to evaluate the differences in the efficacy of treating excessive gingival display with the standard modified lip repositioning surgery or the modified lip repositioning surgery with dual-layered suturing. Methods: This study included 20 female patients who had a gummy smile resulting from upper lip hypermobility or short upper lip. Preoperative measurements of the amount of gum exposure were taken during involuntary smiling. The patients were randomly divided into two groups; the first group was treated with the standard technique, whereas the second group was treated with the double-layered suturing method. All patients were followed up at 14 days, 3 months, and 6 months; postoperative assessment was done by measuring the changes in the gingival display during spontaneous smiling. Results: Postoperative measurements at 14 days follow-up showed a significant reduction in the amount of gingival exposure in both groups. However, at 3 months, there was a complete relapse for the first group of patients, whereas the second group showed a slight regain in the amount of gum exposure, though the latter group showed a complete relapse at 6 months postoperative. Conclusions: The dual-layered suturing for the modified lip repositioning surgery did not provide any long-term improvement for treating gummy smile patients; however, it did delay the relapse to a certain extent for the first 3 months postoperative in some of the patients.