الفهرس 
Evaluating lip repositioning technique with and without myotomy for the treatment of excess gingival display
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Abstract
Lip repositioning is a conservative surgical method for the correction of excess gingival display (EGD) by limiting the upward retraction of the lips. Lip repositioning presents a simple and enduring method for the treatment of gummy smile; however, the literature is limited on this topic. The aim of this RCT was to assess lip repositioning as a technique and compare it in terms of outcome and stability to lip repositioning with muscle severance. A randomized, single-blind, controlled, parallel-group clinical trial was performed. Twenty patients with excess gingival display were enrolled in the study: 10 patients were treated with classic lip repositioning and 10 patients were treated with lip repositioning with muscle severance. Subjects were assessed for gingival display reduction, changes in lip length and result stability at 3, 6 and 12 months. Furthermore, subject center outcomes including pain, swelling and satisfaction were assessed by both the subject and blinded assessors that included dentists and lay people. Classical lip repositioning was found capable of reducing EGD by 2.73mm (SD ±1.281), increasing philtrum length by 1.77mm (SD ±1.04) and vermilion border thickness by 1.23 (SD ± 0.47). Lip repositioning with muscle severance offered an improved reduction in EGD with a mean reduction of 3.57mm (SD ±1.62), but a comparable increase in philtrum and vermillion border dimension of 1.78mm (SD ±0.73) and 1.55mm (SD ± 0.81) respectively. Muscle severance was found to be statistically superior in terms of EGD reduction and result stability at 12 months but comparable in all other aspects to the classical technique. Patient centered outcomes including swelling, pain and satisfaction were found to be comparable between the two techniques