Overview

A gummy smile can negatively affect a patient's self-confidence and satisfaction with their appearance, leading many individuals to seek effective esthetic solutions. The etiology of this condition varies and may include vertical maxillary excess, short upper lip, hyperactive upper lip, gingival enlargement, or altered passive eruption.

Lip Repositioning Surgery is one of the minimally invasive esthetic surgical procedures used to reduce the amount of gingival display during smiling. Despite its effectiveness, this surgery may be associated with challenges such as pain, swelling, delayed wound healing, and the possibility of postoperative relapse over time, which could compromise both esthetic and functional outcomes.

To overcome these challenges and enhance surgical outcomes, adjunctive techniques have been introduced to promote healing and determine whether enhancing the biological healing process can reduce the rate of relapse after LRS. Among the most prominent of these are Injectable Platelet-Rich Fibrin (i-PRF) and Low-Level Laser Therapy (LLLT).

Eligibility

Inclusion Criteria:

1. Patients of both genders.
2. Patients presenting with a gummy smile in the maxillary anterior region (more than 3 mm) due to upper lip hypermobility.
3. Age 18-50 years.
4. Systemically healthy individuals, classified as ASA physical status I or II according to the American Society of Anesthesiologists (ASA) classification; that is, patients without systemic disease or with mild, well-controlled systemic conditions.
5. Patients with good oral hygiene, defined as an O'Leary Plaque Index ≤ 40%.
6. No previous lip repositioning surgery.

Exclusion Criteria:

1. Pregnancy and lactation.
2. Individuals with a previous history of receiving facial Botox or filler injections.
3. Systemic diseases or conditions that contraindicate the use of local anesthesia.
4. Any physical condition that impairs the ability to perform proper oral hygiene measures.
5. Patients who are smokers or alcohol consumers.
6. Inability or unwillingness to cooperate.
7. In adequate width of attached gingiva.
8. Vertical maxillary excess (moderate to severe) requiring orthognathic intervention.
9. Short upper lip
10. Gingival display primarily caused by altered passive eruption requiring crown lengthening.