Asociación entre el biotipo facial y la posición del labio superior en la sonrisa / Association between facial biotype and the position of upper lip of the smile

Introducción: Para obtener una sonrisa ideal, es necesario que todas sus partes estén en armonía, mediante un equilibrio neurológico, muscular y esquelético. Así pues, la elaboración de un análisis facial y de sonrisa en el diagnóstico de ortodoncia, resulta de vital importancia, ya que la estética dental está muy relacionada conel tipo de sonrisa y el biotipo facial. Objetivo: determinar si existe asociación entre el biotipo facial y la posición del labio superior en la sonrisa. Material y métodos: el estudio es de tipo descriptivo, transversal y observacional. El universo de estudio fueron 1200 casos de la base de datos de la clínica de Posgrado de la Universidad Autónoma de Nayarit, México del año 2013 al 2023. La muestra fue de 120 pacientes pretratamiento de ortodoncia, analizando en ellos el biotipo facial y la altura de la línea de sonrisa. Se realizó la estadística descriptiva, pruebas de chi-cuadrado y V de Cramer. Resultados: el 34% presentó un biotipo braquifacial, el 31% dolicofacial y un 35% mesofacial. Se encontró en mayor porcentaje una línea de la sonrisa alta. En los pacientes dolicofaciales y mesofaciales la línea de sonrisa fue alta y en los pacientes braquifaciales fue media. La asociación entre el biotipo facial y la línea de sonrisa fue grande. Conclusiones: existe asociación entre el biotipo facial y la línea de sonrisa por lo que al realizar el diagnóstico en ortodoncia debe ser un factor a considerar. (AU)

Introduction: To obtain an ideal smile, it is necessary that all its parts are in harmony, through neurological, muscular and skeletal balance. Therefore, carrying out a facial and smile analysis in orthodontic diagnosis is of vital importance, since dental aesthetics is closely related to the type of smile, and the facial biotype. Objective: Determine if there is an association between facial biotype and the position of the upper lip in the smile. Material and Methods: The study is descriptive, cross-sectional and observational. The study was made of 1,200 cases from the database of the Postgraduate clinic of the Universidad Autónoma de Nayarit, Mexico from 2013 to 2023. The sample was 120 orthodontic pretreatment patients, analyzing their facial biotype and the height of the smile line. Descriptive statistics, chi square and Cramer’s V tests were performed. Results: 34% presented a brachyfacial biotype, 31% dolichofacial and 35% mesofacial. A high smile line was found in a higher percentage. In the dolichofacial and mesofacial patients the smile line was high and in the brachyfacial patients it was medium. The association between facial biotype and smile line was big. Conclusions: There is an association between the facial biotype and the smile line, so when making the orthodontic diagnosis it should be a factor to consider. (AU)

A digital technique of bone reduction for a maxillary full-arch implant-supported fixed dental prosthesis.

When fabricating a maxillary full-arch implant-supported fixed dental prosthesis, it is often challenging to systematically reduce alveolar bone to create prosthetic space and hide the prosthesis-tissue junction. This article presents a digital technique that allows for precise bone reduction while simultaneously placing implants and interim prostheses. By using this technique, clinicians can perform surgical procedures in a systematic manner without compromising the functional or esthetic outcomes.

Relationship between smile type and periodontal phenotype: A clinical and tomographic cross-sectional study.

OBJECTIVES: To evaluate the correlation between smile type (ST) and the periodontal phenotype (PP). MATERIAL AND METHODS: Clinical and photographic examinations of 164 participants (48 men and 116 women, mean age 22.9 ± 4.6 years) were performed, including an evaluation of ST (high, average, and low), gingival phenotype (GP) by transparency of the periodontal probe (TRAN), keratinized tissue width (KTW), gingival architecture (GA), tooth shape (TS), and papilla height (PH). A subgroup of 70 participants underwent soft-tissue cone-beam tomographic examinations (ST-CBCT), in which GP, gingival thickness (GT), buccal bone thickness (BBT), and the distances from the gingival margin and cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC) were evaluated. The data were analyzed using one-way ANOVA, Student's t-test, and chi-square tests, with the level of significance set at 0.05. RESULTS: High, average, and low STs were found in 31.7%, 56.7%, and 11.6% of the participants, respectively. Sex (p=0.001), GP evaluated using TRAN (p=0.021) and ST-CBCT scans (p=0.009), GA (p<0.001), and TS (p=0.001), were associated with STs. The prevalence of thin GP was: 63% in low, 50% in average, and 38% in high smile types. KTW (p=0.004), PH (p<0.001), GT at different landmarks (p<0.05), CEJ-BBC (p=0.017), and GM-BBC (p=0.001) were significantly different among STs. The highest GT and KTW were found in the high-smile group, average-smile presented the higher CEJ-BBC while GM-BBC and PH, were higher in low-smile group. CONCLUSION: Periodontal phenotype components presented important difference over the smile types. CLINICAL RELEVANCE: A detailed examination of smile types is an essential part of treatment planning, especially when the patient has high esthetic demands. Clinical and tomographic individual analysis of periodontal phenotypes over the smile types may be helpful for a case-by-case approach, and for the development of well-defined treatment protocols.

Analysis of gingival display during static and dynamic smiles in a Turkish sample: A clinical study.

Purpose: The aim of this study is to determine the prevalence of smile types in spontaneous smiles among a Turkish population aged 18-23 and to compare it with the prevalence of static smiles. Materials and methods: This study was carried out with 150 undergraduate students at Baskent University Faculty of Dentistry (75 females, 75 males). For this purpose, photo recordings for static smiles and 20-second video recordings for dynamic smiles were taken 40 cm from the participant's nose. Measurements were made with an electronic ruler. Results: High smile line was found to be the highest prevalence in both static and dynamic smiles (p<0.001). The average soft tissue display is higher in dynamic smiles (p<0.05). In both static and dynamic smiles, the average amount of gingival display was higher in females than in males (p<0.05). Conclusion: When the smile line was evaluated on the photograph recordings while the patient was posing, it was found to be lower than the natural spontaneous smile line obtained from the video recordings. Since the gingival display increases when patients smile naturally instead of posing, clinical evaluations and restorative considerations should be planned according to the dynamic smile.

The Influence of the Maxillary Posterior Region on Smile Aesthetics in a Chinese Cohort.

OBJECTIVES: The aim of this research was to establish standard norms for posterior smile-related characteristics including posterior smile line (PSL), the most posterior teeth displayed, buccal corridor ratio (BCR), and buccal corridor symmetry (BCS) and investigate its aesthetic contributions to smile attractiveness in a Chinese population. MATERIALS AND METHODS: From digitally recorded dynamic smile videos of young Chinese participants, 188 standardised full-smile images were captured and then aesthetically evaluated by 22 laypersons using a visual analog scale (VAS). Four smile-related variables in the posterior region were analysed. VAS data were compared between subgroups to test the influence of these variables on smile aesthetics with significance level of P < .05. RESULTS: The VAS scores of participants with high PSL were significantly lower than those with average or low PSL (P < .01), especially when they display average or low anterior smile line (P < .05). Smiles with the second premolar displayed obtained the highest VAS amongst the 3 subgroups (P < .05). No significant differences were found between the VAS scores of BCR and BCS (P > .05). CONCLUSIONS: Maxillary posterior gingiva and teeth displayed influence smile attractiveness evaluated by laypersons, which should be given attention when treating patients with compromised aesthetics, especially those displaying average or low anterior smile lines.

Aesthetic rehabilitation in a patient with skeletal mandibular deficiency and open bite: journey from splinted metalloceramic prosthesis to all-ceramic crowns.

This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for localised periodontal disease and poor aesthetics. At multiple sites the ceramic had chipped off and the prosthesis colour did not match with the adjacent healthy teeth. A multidisciplinary approach of endodontics, periodontics and prosthodontics was employed for this case. The treatment plan consisted of removing the faulty prosthesis, endodontic retreatment of inadequately root-treated teeth and endodontics in the other coronally prepared abutment teeth. Crown lengthening surgery was performed for the correction of periodontal pockets and high smile line and maintenance of an adequate biological width. After periodontal healing, all-ceramic individual crowns were placed on the maxillary anterior teeth along with a three-unit all-ceramic bridge for the replacement of the left upper maxillary first premolar. The final results were aesthetically pleasing with good marginal fit. The patient was extremely satisfied with the outcome as all her concerns were addressed. It is, therefore, advisable to consider placing individual crowns rather than multiunit splinted prosthesis whenever possible.

Association of the nasolabial angle and lip length with the gingival and interdental smile line-A gender based evaluation.

OBJECTIVE: Proportionate existence of the lip framework and gingival scaffold have a critical role in smile esthetics. So, the present study was conducted to assess and correlate the nasolabial angle (NLA) and lip length (LL) with gingival smile line (GSL) and interdental smile line (ISL). MATERIALS AND METHODS: One hundred and twenty periodontally healthy patients with an age group 20 to 40 years were equally divided based on gender into two groups. The parameters of NLA, LL, GSL, ISL, amount of midfacial gingiva, and interdental papilla display were recorded in the maxillary anterior sextant. RESULTS: The mean values of NLA and LL at rest and on smiling were found to be higher in males. Majority of study population exhibited Low GSL (LGSL) and High ISL (HISL). On correlation of LL with GSL, the difference in the mean values between males and females for LGSL were highly significant, for HGSL and Cupid's bow the values were significant. The mean values of midfacial gingiva and interdental papilla visible in females was greater than males. CONCLUSION: The NLA and LL influence the quantum of gingival exhibit in maxillary anterior teeth with a definitive sexual dimorphism and this can be considered a valuable reference point in smile designing procedures. CLINICAL SIGNIFICANCE: The quantum of gingival exhibit on smiling is an important feature in periodontal, implant, restorative, and smile designing procedures in patients possessing HGSL and HISL category of GSL and ISL. It is indicated that the lip length is correlated with the amount of gingival tissue display both in midfacial as well as interdental region and which needs to be considered by the clinician.

The Influence of Varying Gingival Display of Maxillary Anterior Teeth on the Perceptions of Smile Aesthetics.

OBJECTIVES: The aim of the study was to investigate the influence of gingival display on perceived smile aesthetics and to compare aesthetic gingival display preference amongst dental professionals and lay people. METHODS: This cross-sectional study was based on the analysis of quantitative data collected via questionnaires. Two sets of digitally altered smile images with variations of gingival amount and architecture displays were produced. Ranking order scale was used to record aesthetic preferences, from the most attractive to the least attractive. RESULTS: There were 124 respondents (60 lay people, 32 general dentists [GDPs] and 32 orthodontists). Average smile line, tangent to the zeniths of maxillary anterior teeth, was found to be the most attractive gingival amount (53.2%, χ2 = 144.15, p < 0.045) amongst lay people, GDPs and orthodontists. High smile line was ranked as the least attractive amount amongst all respondents (88.7%, χ2 = 359.37 p < 0.002). Class III gingival outline, where all gingival levels are symmetrical and in line, was found as the most attractive gingival architecture (65.3%, χ2 = 10.87 p < 0.001). CONCLUSION: No particular amount of gingival display is universally perceived as attractive although high smile lines are generally disliked. Class III gingival architecture is the most preferred gingival archetype when excessive amount of maxillary gingiva is exposed. CLINICAL SIGNIFICANCE: A general acceptance to smile line variations demonstrates that the harmony amongst all smile components is more important than merely focusing on a single ideal smile constituent. However, when designing the smile with an inherent high lip line, a Class III gingival architecture might be more preferable since it reduces the negative impact of excessive gingival display.

Impact of assessing smile parameters as part of orthodontic treatment planning - a survey based analysis.

BACKGROUND: Smile forms an imporatnt aspect of facial analysis, as it contributes to overall facial esthetics. Many orthodontists pay more attention to cephalometric radiograph; and profile assessment to improve their patients' esthetics; however, the facial attractiveness of the individuals is obviously improved through enhancing their smiles. This study was aimed at evaluating the impact of analyzing certain smile esthetic parameters on diagnosis and treatment plan for individuals seeking orthodontic treatment. MATERIALS AND METHODS: An electronic questionnaire with 24 questions arranged on five main axes was designed. These axes included smile arc, smile line, buccal corridors, smile symmetry, and photographic analysis of the smile, with several questions in each axis. The electronic link of the questionnaire was sent to all members of the Iraqi Orthodontic Society in April 2019. The answers were collected after 4 weeks of questionnaire link distribution date. RESULTS: Among the surveyed orthodontists, there was a consistent agreement to assess the smile arc, smile line, buccal corridors, and smile symmetry, with main axes scores (4.14 ± 0.81, 4.1 ± 0.79, 3.86 ± 0.82, and 4.16 ± 0.86 respectively). Moreover, the participants prefer, with 3.89 ± 0.86 main axis score, to use the facial photograph for a less time-consuming and detailed evaluation of smile features. CONCLUSIONS: Smile parameters, for example, smile arc, smile line, buccal corridors, and smile symmetry are better to be analyzed using photographs during orthodontic diagnosis and treatment planning.

Evaluation of the maxillary midline, curve of the upper lip, smile line and tooth shape: a prospective study of 140 Caucasian patients.

BACKGROUND: A number of reference patterns such as the interincisal line, curve of the upper lip, width of the smile or shape of the teeth have been studied in different populations. Determining the frequency of different smile aesthetic parameters in a European Caucasian population and exploring possible gender differences is important in order to obtain predictable treatment outcomes. METHODS: Photographs were obtained under resting and forced smiling conditions in 140 individuals (70 males and 70 females) with a mean age of 20.1 ± 4.3 years. Different variables were recorded, including the position of the maxillary interincisal midline in relation to the facial midline, the arc and width of the smile, and the shape of the teeth. The data were processed using the SPSS version 15.0 statistical package, with application of the chi-squared test and a confidence level of 95%. The statistical power was 80%, and the level of significance 5% (α = 0.05). RESULTS: A total of 94.3% of the sample presented a maxillary interincisal midline coinciding with the facial midline, and 80% had a consonant smile line. The curve of the upper lip was upwards in 47.1% of the cases, followed by a straight curve in 41.4%. Most of the subjects (84.3%) presented a medium smile line with tooth exposure to the second premolar (61.4%). There were no significant differences between males and females. CONCLUSIONS: The integration of aesthetic criteria is needed in order to guarantee satisfactory and predictable dental treatment outcomes. There were no statistically significant differences between males and females. The maxillary interincisal midline coincided with the facial midline, with a consonant smile arc and a medium smile line, upward lip curve and oval tooth shape.

Minimally invasive (flapless) crown lengthening by erbium:YAG laser in aesthetic zone.

Crown lengthening is a surgical procedure aimed at exposure of a larger tooth surface by gingivectomy alone or with cortical bone remodelling for aesthetic purposes in the anterior zone of the maxilla or for reconstruction of teeth affected by subgingival caries. We report two cases of crown lengthening in the anterior maxilla for aesthetic purposes by gingival and bone re-contouring performed by erbium-doped yttrium aluminium garnet (erbium:YAG) laser. As highlighted in this report, the erbium:YAG laser-assisted crown lengthening is less invasive and also leads to faster clinical outcomes in contrast to the conventional surgical technique by scalpel incision, flap elevation and osteoplastic.

Association of the gingival line angle with the gingival and interdental smile line: A gender based evaluation.

OBJECTIVE: Gingival line angle (GLA) has been considered an important attribute of an esthetic smile. The purpose of this study was to evaluate GLA on either sides of maxillary arch and correlate it with the gingival smile line (GSL) and interdental smile line (ISL). MATERIALS AND METHODS: One hundred twenty periodontally healthy patients with an age range of 20-40 years, equally divided into males and females were included. Standardized digital photographs were taken for assessment of the interdental papillae and smile line. Study models of the participants were used to record the GLA. Gingival thickness (GT) was measured clinically. RESULTS: Although there was consistent difference between the values, the correlation between GLA and GT on either sides of the arch did not indicate positive association. It was revealed that maximum of patients that is, 76.67% and 75% of males and females respectively possessed low GSL. CONCLUSIONS: Although there is a difference between GT and GLA, the difference was statistically insignificant. Majority of the study population exhibited low GSL and high ISL, thereby indicating greater importance for interdental papillae in designing an esthetic smile. CLINICAL SIGNIFICANCE: Considering the likely variations based on gender on gingival line angle and the tooth and gingival display in interdental smile line and gingival smile line, these parameters need to be assessed further. It is believed that appropriate assessment of these parameters would enable the clinician to adopt these relationships as guidelines for interdisciplinary treatment procedures.

Does overbite reduction affect smile esthetics?

OBJECTIVES: To compare the effects of two common methods of overbite reduction on smile esthetics. MATERIALS AND METHODS: A prospective clinical trial was conducted with 32 patients in whom overbite reduction was achieved using a maxillary incisor intrusion arch (18 patients) or flat anterior bite plate (14 patients). Clinical and cephalometric records were compared pretreatment (T1), after overbite reduction (T2), and posttreatment (T3). RESULTS: Both treatment groups experienced a reduction in overbite and maxillary and mandibular incisor proclination during treatment (T1-T3). The center of resistance of the maxillary incisor and the incisal edge was significantly intruded in the intrusion arch group during overbite reduction (T1-T2). However, most of the intrusion of the center of resistance was lost by the end of treatment (T2-T3). Both treatment groups experienced a reduction in maxillary incisor display and flattening of the smile arc during overbite reduction. CONCLUSIONS: Both overbite reduction methods caused a decrease in incisor display and flattening of the smile arc. Smiles were improved in some patients by the end of treatment. However, reduction in incisor display persisted. Clinicians should take precautions to prevent negative effects of overbite reduction.

Multidisciplinary approach with predictable esthetics: A case report.

This case report explains an effective multidisciplinary approach used to improve the function, biology, and esthetic of a patient presented with an excessive gingival display, a spacing between anterior teeth, small size anterior teeth in maxilla and mandible. Also, unrestorable molars were noted with multiple carious lesions. The treatment combined crown lengthening, prosthetic dentistry using lithium disilicate crowns and minimally invasive implants placement approach.

Layperson's Esthetic Preference to the Presence or Absence of the Interdental Papillae in the Low Smile Line: A Web-based Study.

PURPOSE: To determine the layperson's esthetic preference to the visual display (presence) or lack thereof (absence) of the interdental papillae during minimum smiling or the low smile line patient type. MATERIALS AND METHODS: Two hundred lay-people were shown three-paired smile images indicative of a low gingival smile line patient type in which the vermillion border of the maxillary lip covered the mid-facial gingiva of the anterior teeth. The three images differed only with respect to [1] presence of interdental papillae, [2] absence of the interdental papilla ("black triangle"), or [3] absence of the interdental papillae (replaced with a long restorative contact area). The three images were paired in multiple groupings; group-1 consisted of a comparison of the presence of interdental papillae vs the lack of the interdental papillae "black triangle," group-2 compared the long restorative contact compared to the presence of the interdental papillae and Group-3 compared the long restorative contact replacing a missing papilla to the absence of the interdental papillae "black triangle." The comparisons were designed to determine the subjective preference of lay individuals between these groupings. RESULTS: Ninety-eight percent of lay-people demonstrated a preference to the presence of the interdental papillae in the smile (image 1) when compared to its absence ("black triangle"; image 2) with a low smile line. Seventy percent preferred the visual display of the interdental papillae, that is, pink tissues (image 1), compared to the absence of the interdental papillae replaced with a long contact area (image 3), that is, white restorative materials, when viewing a low gingival smile line. And when comparing the absence of the interdental papillae "black triangle" to a long contact area, 92% of lay-people preferred a long contact area vs the absence of the interdental papillae with a "black triangle" with a low smile line. CONCLUSIONS: The visual display [presence] of the interdental papillae, that is, pink tissues, is notably preferred to the absence of the interdental papillae when replaced by either a "black triangle" or long contact area in the commonly known low smile line. This emphasizes the need to assess the Interdental Smile Line (ie, visual display of interdental papillae during smiling) in all patients and the importance to preserve and/or re-establishment of the interdental papillae, that is, pink tissues, even in patients with a low smile line.

Functional and esthetic improvement through systematic diagnosis and treatment procedures in patient with unaesthetic anterior teeth proportion because of tooth wear: A case report / 대한치과보철학회지

It is reported that the causes of unaesthetic proportion of anterior teeth vary widely. Especially, when the unaesthetic tooth proportion of the mandibular incisors arises due to the wear of the anterior teeth accompanied by the compensation of the alveolar bone, it may cause serious functional and aesthetic problems. In such case, it should be considered that the evaluation of vertical dimension and tooth proportion as well as smile line, soft tissue and hard tissue morphology. And, increase of vertical dimension or clinical crown lengthening followed by prosthodontic restorations is needed to improve the interdental mesial/distal, width/length ratio considering the anterior guidance. This case report demonstrates functional and aesthetic improvements through systematic diagnosis and treatment procedures in a 48-year-old male patient with unaesthetic anterior teeth proportion because of tooth wear accompanied by the compensation of alveolar bone and defect of several central incisors due to chronic periodontitis.

Anterior open-bite treatment by means of zygomatic miniplates: a case report.

This case report presents the treatment of a patient with skeletal Cl II malocclusion and anterior open-bite who was treated with zygomatic miniplates through the intrusion of maxillary posterior teeth. A 16-year-old female patient with a chief complaint of anterior open-bite had a symmetric face, incompetent lips, convex profile, retrusive lower lip and chin. Intraoral examination showed that the buccal segments were in Class II relationship, and there was anterior open-bite (overbite -6.5 mm). The cephalometric analysis showed Class II skeletal relationship with increased lower facial height. The treatment plan included intrusion of the maxillary posterior teeth using zygomatic miniplates followed by fixed orthodontic treatment. At the end of treatment Class I canine and molar relationships were achieved, anterior open-bite was corrected and normal smile line was obtained. Skeletal anchorage using zygomatic miniplates is an effective method for open-bite treatment through the intrusion of maxillary posterior teeth.

Implant Rehabilitation Planning Protocol for the Edentulous Patient According to Denture Space, Lip Support, and Smile Line.

Rehabilitation with implants is a challenge. Having previous evaluation criteria is key to establishing the best treatment for the patient. In addition to clinical and radiological aspects, the prosthetic parameters must be taken into account in the initial workup, since they allow discrimination between fixed and removable rehabilitation. We present a study protocol that analyzes three basic prosthetic aspects. First, denture space defines the need to replace teeth, tissue, or both. Second, lip support focuses on whether or not to include a flange. Third, the smile line warns of potential risks in esthetic rehabilitation. Combining these parameters allows us to make a decision as to the most suitable type of prosthesis. The proposed protocol is useful for assessing the prosthetic parameters that influence decision making as to the best-suited type of restoration. From this point of view, we think it is appropriate for the initial approach to the patient. In any case, other considerations of study may amend the proposal.

An Evaluation of Benchmarks for Esthetic Orientation of the Occlusal Plane.

PURPOSE: This patient study was designed to measure the validity of both the horizontal and Camper's planes, which are used as benchmarks to reestablish the sagittal orientation of the occlusal plane angles in dental rehabilitation. MATERIALS AND METHODS: Profile digital photographs were made of the first 100 consenting dentate patients as they closed on an occlusal plane analyzer while maintaining natural head posture. Using a digital screen protractor, three angles were measured: the occlusal plane angle relative to the horizontal plane, and the angle between the occlusal plane and Camper's plane from both the superior and inferior borders of the tragus of the ear. RESULTS: The angle between the occlusal plane and the horizontal reference plane for the 100 patients ranged from -8.72° to +18.08° (mean +3.25°); the angle between the occlusal plane and Camper's plane, from the superior border of the tragus to the ala of the nose demonstrated a range from -8.49° to +15.16° (mean +3.03°); and the angle between Camper's plane, from the inferior border of the tragus to the ala of the nose and the occlusal plane demonstrated a range from -15.57° to +9.15° (mean -4.09°). CONCLUSIONS: Occlusal plane angles measured in this patient population with natural dentitions demonstrated a relatively small mean deviation from both the horizontal plane and Camper's plane when using the superior border of the tragus as the distal reference point, but the range was quite broad and could result in unacceptable occlusal plane angles in many patients undergoing dental rehabilitation. CLINICAL IMPLICATIONS: Both Camper's plane and the horizontal reference plane may be acceptable initial reference planes for oral rehabilitation, but additional anatomic and esthetic parameters are required for verification of an esthetically pleasing occlusal plane angle.

Estudo sobre excessiva mostra gengival / Study on excessive gingival shows

O objetivo dessa revisão foi buscar na literatura o que há de mais relevante e atual sobre o tema Excessiva Mostra Gengival (EMG). Foram incluídos os aspectos de como identificar a condição do que é a EMG, de como avaliar cada paciente portador da EMG e suas características e manifestações, como classificar cada caso e como essa classificação vai influenciar no desenrolar do tratamento. Para esse estudo, foi realizada uma pesquisa bibliográfica no Banco de dados PUBMED, utilizando as palavras-chave: excessive gingival display, lip reposition, smile line, smile design, gummy smile, smile, aesthetic factors in a smile, aesthetic smile. Foram pesquisados 90 trabalhos relacionados a esse tema e também 4 livros foram envolvidos na busca. Destes 90 Artigos, 40 foram utilizados, tendo maior relevância para essa obra. Também foi feita uma busca utilizando palavras em Língua Portuguesa, com as palavras-chave: reposicionamento do lábio superior, excessiva mostra gengival, sorriso gengival, linha do sorriso. Após esse estudo, as conclusões foram: as EMG são classificadas em cinco tipos, com diferentes etiologias. Para cada tipo de EMG existe um tratamento indicado, sendo na maioria das vezes cirúrgico. A EMG quando associada a alterações periodontais são tratadas com cirurgias de menor complexidade e com alta previsibilidade de sucesso. A técnica de mudança de posicionamento do lábio superior (LipStat) mostra ser uma forma bastante promissora para o tratamento de EMG complexa e, finalmente, pesquisas futuras são necessárias para avaliar resultados a longo prazo.(AU)

The objective of this review is to search in the literature the most relevant and updated regarding to the theme Excessive Gingival Display ( EGD ). This search has dealt with the aspects regarding the identification of this condition , what exactly it is that condition , how to evaluate each patient who portrait this situation and identify all relevant characters of the condition EGD . And how this character will influence upon the treatment. For this piece, a search was performed through the database PUBMED, utilizing the key-words: excessive gingival display, lip repositioning, smile line, smile design , gummy smile, smile, aesthetic factors in a smile , aesthetic smile. Searches gathered 90 Articles which were related to the matter and 4 books were involved, too. From these 90 Articles, 40 Articles were utilized, having more relevance. Some words in Portuguese Language were used to perform a search, too. After this search in the literature, conclusions were made: the EDG is classified in five different types, with different etiologies. For every kind of EDG, there is a different kind of treatment, most of them through surgery. The EDG, when associated to periodontal problems are treated by minor complex surgeries, having highly visibility of success. The technique of upper lip repositioning (lipStat) has shown to be a good way to solve the EGD complex cases and finally, future researches are necessary to evaluate long term outcomes.(AU)