Abstract

Interdisciplinary solutions. Restorative choices during the adolescent-to-adult transition in the presence of a high smile line. Localized gummy smile. Asymmetric gummy smile.

by Perakis Nikolaos

The gummy smile is an important clinical assessment that cannot be considered per se a pathology. Nevertheless it is acting as a magnifying glass for any dental or gingival disharmony of the smile. For this reason, its presence significantly influences any therapeutic decisions often involving different dental disciplines. Gummy smile and its solution is strictly related to growth, age and chief complaint of the patient. A Gummy smile can be anterior, posterior, total or regional; symmetric or asymmetric. Differential diagnosis of the different causes is essential to find the best clinical solution. Depending on the case, Orthodontics can be involved in inducing vertical growth restriction, vertical control mechanics, selective intrusion with or without TADs. Periodontics needs to address the different form of Altered Passive Eruption and can be involved in compensating skeletal issues or asymmetric gummy smile with different types of perio surgery. Prosthodontics and Restorative Dentistry should find solutions that will take into account the presence of a high smile line and the degree of gingival development to offer predictable solutions during the delicate transition from adolescence to young adulthood and at a more mature age. The gummy smile is often due to a Vertical Maxillary Excess (VME) within a context of a more complex skeletal discrepancy affecting the face of the patient. Orthognathic surgery can be requested when the skeletal discrepancy is more severe or when the legitimate requests of the patient require a comprehensive approach within the context of an orthofacial approach. We can certainly affirm that “Gummy Smile” is a clinical conditions that requires an interdisciplinary know how.