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Volume 13
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10.3390/jcm13226843
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Systematic Review

Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments

by
Alessio Danilo Inchingolo
1,†,
Angelo Michele Inchingolo
1,†,
Fabio Viapiano
1,
Anna Netti
1,
Anna Maria Ciocia
1,
Irene Ferrara
1,
Antonio Mancini
1,
Andrea Palermo
2,
Francesco Inchingolo
1,* and
Gianna Dipalma
1
1
Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
2
College of Medicine and Dentistry, Birmingham B4 6BN, UK
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work as first authors.
J. Clin. Med. 2024, 13(22), 6843; https://doi.org/10.3390/jcm13226843
Submission received: 14 October 2024 / Revised: 7 November 2024 / Accepted: 9 November 2024 / Published: 14 November 2024
(This article belongs to the Topic Oral Health Management and Disease Treatment)
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Abstract

Background/Objectives: This systematic review seeks to assess the effectiveness of different orthodontic and combined orthodontic–surgical approaches for correcting gummy smile, with a focus on treatment efficacy, duration, and the potential for integrating various techniques. The objective is to offer evidence-based recommendations for the optimal management of gummy smile. Methods: A thorough search of the literature was conducted in the PubMed, Cochrane Library, Scopus, and Web of Science databases, covering publications from 1 January 1982 to 4 November 2024. Only randomized controlled trials involving adult human subjects with available full-text articles were included, while systematic reviews, editorials, case reports, and studies involving animals or in vitro experiments were excluded. Studies were selected based on their relevance to orthodontic or combined orthodontic–surgical treatments for correcting excessive gingival display (gummy smile), particularly in cases where residual growth does not impact treatment outcomes. The primary focus was on evaluating the efficacy of these interventions in improving smile aesthetics. Follow-up data were considered when available, though not required for inclusion. Results: The findings revealed that both orthodontic and surgical methods are effective in reducing gingival display. Orthognathic surgery offers lasting outcomes, particularly for patients with vertical maxillary excess, whereas orthodontic treatments, including the use of skeletal anchorage devices, are particularly effective for less severe cases. Minimally invasive approaches, such as botulinum toxin injections, provided temporary but promising results for patients reluctant to undergo surgery. Conclusions: Orthodontic and surgical techniques are viable options for treating gummy smile, with treatment choices depending on the condition’s severity. Future research, particularly long-term randomized studies, is required to further refine treatment protocols and improve patient outcomes.
Keywords: gummy smile; gingival display; orthodontic; skeletal anchorage devices; vertical maxillary excess; aesthetics gummy smile; gingival display; orthodontic; skeletal anchorage devices; vertical maxillary excess; aesthetics

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MDPI and ACS Style

Inchingolo, A.D.; Inchingolo, A.M.; Viapiano, F.; Netti, A.; Ciocia, A.M.; Ferrara, I.; Mancini, A.; Palermo, A.; Inchingolo, F.; Dipalma, G. Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments. J. Clin. Med. 2024, 13, 6843. https://doi.org/10.3390/jcm13226843

AMA Style

Inchingolo AD, Inchingolo AM, Viapiano F, Netti A, Ciocia AM, Ferrara I, Mancini A, Palermo A, Inchingolo F, Dipalma G. Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments. Journal of Clinical Medicine. 2024; 13(22):6843. https://doi.org/10.3390/jcm13226843

Chicago/Turabian Style

Inchingolo, Alessio Danilo, Angelo Michele Inchingolo, Fabio Viapiano, Anna Netti, Anna Maria Ciocia, Irene Ferrara, Antonio Mancini, Andrea Palermo, Francesco Inchingolo, and Gianna Dipalma. 2024. "Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments" Journal of Clinical Medicine 13, no. 22: 6843. https://doi.org/10.3390/jcm13226843

APA Style

Inchingolo, A. D., Inchingolo, A. M., Viapiano, F., Netti, A., Ciocia, A. M., Ferrara, I., Mancini, A., Palermo, A., Inchingolo, F., & Dipalma, G. (2024). Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments. Journal of Clinical Medicine, 13(22), 6843. https://doi.org/10.3390/jcm13226843

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