Tratamento do sorriso gengival através de cirurgia plástica periodontal, reposicionamento labial e toxina botulínica: relato de caso clínico

Abstract

Popularly known as gummy smile, excessive gingival display is a term used to describe the occurrence of exaggerated maxillary gingival display during smiling. The aim of the present study was report a clinical case of a 40-year-old patient who was referred to the dental clinic of Federal Universitiy of Juiz de Fora – Gov. Valadares Campus, with a chief complaint of dissatisfaction with the smile. After clinical and tomographic examination, was observed excessive gingival display, with gingival exposure of ≥ 7 mm visibility during dynamic smile resulting in the diagnosis of lip hypermobility and occurrence of bone plate thickening. Periodontal plastic surgery, lip repositioning and application of botulinum toxin were proposed as a treatment method. Initially, since the patient had bone volume discrepancy, mucogingival surgery associated with osteoplasty was performed to improve the gingival architecture. After observing an improvement in the smile disposition in relation to the the clinical crown teeth size, in another clinical appointment, lip repositioning surgery was performed associated with the use of botulinum toxin, applied to the depressor septum nasalis muscle, levator labii superioris alaeque nasalis muscle, and levator labii superiores muscle. After suture removal and postoperative follow-ups, gigival exposure of 1 to 2 mm was observed during smiling and the patient reported being quite satisfied with the result achieved. The patient was followed-up for one year, and the result remained stable.