Eficacia del reposicionamiento de labios en el tratamiento de la exposición gingival excesiva: revisión sistemática y metanálisis

Autores/as

  • Juliana Couto e Silva Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. http://orcid.org/0000-0001-9897-7263
  • Lucas Guimarães Abreu Department of Paediatric Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. http://orcid.org/0000-0002-0165-7501
  • Fabiano Araújo Cunha Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. http://orcid.org/0000-0002-1141-8563
  • Bárbara Lopes Freire Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. http://orcid.org/0000-0002-8045-5114
  • Rafael Paschoal Esteves Lima Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil http://orcid.org/0000-0003-4343-3845

Resumen

Antecedentes: el objetivo de esta revisión sistemática y metanálisis fue responder a las preguntas “¿La cirugía de reposicionamiento de labios reduce la cantidad de encía expuesta en la sonrisa en personas con exposición gingival excesiva (EGE)?” y “¿La reducción de la cantidad de encía expuesto al sonreír obtenido con cirugía de reposicionamiento de labios estable en el tiempo?” para evaluar la efectividad de la cirugía de reposicionamiento de labios para corregir la EGE al sonreír.
Materiales y Métodos: Se realizó una búsqueda sistemática estructurada en cinco bases de datos sin restricción de datos. Se incluyeron los estudios que informaron el grado de reducción de la exposición gingival después de la cirugía de reposición de labios. La selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo se realizaron por duplicado.
Resultados: Se recuperaron ciento sesenta y cuatro referencias y once estudios cumplieron con los criterios de elegibilidad. El metanálisis demostró que la cirugía de reposicionamiento de labios da como resultado una reducción significativa en la cantidad de tejido gingival expuesto (diferencia de medias = -3,03; intervalo de confianza = -3,55; -2,52). Además, los resultados se mantuvieron estables en los periodos de seguimiento evaluados (1, 3, 6 y 12 meses). Los estudios incluidos tenían un bajo riesgo de sesgo.
Conclusión: La cirugía de reposicionamiento de labios es efectiva para el tratamiento de la EGE al sonreír y presenta resultados estables en los períodos evaluados. El estudio fue registrado (CRD42020184866) en el registro prospectivo internacional de revisiones sistemáticas (PROSPERO).
Palabras Clave: Encía; Labio; Sonrisa; Reposicionamiento labial; Exposición gingival excesiva; Cirugía periodontal estética.

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Citas

[1]. Antoniazzi RP, Fischer LS, Balbinot CEA, Antoniazzi SP, Skupien JA. Impact of excessive gingival display on oral health-related quality of life in a Southern Brazilian young population. J Clin Periodontol. 2017 Oct;44(10):996-1002. https://doi.org/10.1111/jcpe. 12753. Epub 2017 Aug 25. PMID: 28555928.

[2]. Bhola M, Fairbairn PJ, Kolhatkar S, Chu SJ, Morris T, de Campos M. LipStaT: The Lip Stabilization Technique- Indications and Guidelines for Case Selection and Classification of Excessive Gingival Display. Int J Periodontics Restorative Dent. 2015;35(4):549-59. https://doi.org/10.11607/prd.2059. PMID:26133145.

[3]. Mele M, Felice P, Sharma P, Mazzotti C, Bellone P, Zucchelli G. Esthetic treatment of altered passive eruption. Periodontol 2000. 2018;77(1):65-83. https://doi.org/10.1111/prd.12206. Epub 2018 Mar 4. PMID: 29504162.

[4]. Aroni MAT, Pigossi SC, Pichotano EC, de Oliveira GJPL, Marcantonio RAC. Esthetic crown lengthening in the treatment of gummy smile. Int J Esthet Dent. 2019;14(4):370-382. PMID: 31549103.

[5]. Zardawi FM, Gul SS, Fatih MT, Hama BJ. Surgical Procedures Reducing Excessive Gingival Display in Gummy Smile Patients With Various Etiologic Backgrounds. Clin Adv Periodontics. 2020 Sep;10(3):130-134. https://doi.org/10.1002/cap.10 089. Epub 2020 Feb 18. PMID: 31954090.

[6]. Dym H, Pierre R 2nd. Diagnosis and Treatment Approaches to a “Gummy Smile”. Dent Clin North Am. 2020;64(2):341-349. https://doi.org/10.1016/j.cden.2019.12.003. Epub 2020 Jan 24. PMID: 32111273

[7]. Mostafa D. A successful management of sever gummy smile using gingivectomy and botulinum toxin injection: A case report. Int J Surg Case Rep. 2018;42:169-174. https://doi.org/10.1016/j.ijscr.2017.11.055. Epub 2017 Dec 1. PMID: 29248835; PMCID: PMC5985251.

[8]. Srivastava S, Kharbanda S, Pal US, Shah V. Applications of botulinum toxin in dentistry: A comprehensive review. Natl J Maxillofac Surg. 2015 Jul-Dec;6(2):152-9. https://doi.org/10.4103/0975-5950.183860.PMID: 27390488; PMCID: PMC492 2224.

[9]. Shemais N, Elarab AE, ElNahass H. The effect of botulinum toxin A in patients with excessive gingival display with and without zinc supplementation: randomized clinical trial. Clin Oral Investig. 2021; 25(11):6403-6417. https://doi.org/10.1007s0 0784-021-03944-2. Epub 2021 May 5. PMID: 3395 0373.

[10]. Rosenblatt A, Simon Z. Lip repositioning for reduction of excessive gingival display: a clinical report. Int J Periodontics Restorative Dent. 2006;26(5):433-7. PMID: 17073353.

[11]. Tawfik OK, El-Nahass HE, Shipman P, Looney SW, Cutler CW, Brunner M. Lip repositioning for the treatment of excess gingival display: A systematic review. J Esthet Restor Dent. 2018 Mar;30(2):101-112. https://doi.org/10.1111/jerd.12352. Epub 2017 Nov 27. PMID: 29193632.

[12]. Dos Santos-Pereira SA, Cicareli ÁJ, Idalgo FA, Nunes AG, Kassis EN, Castanha Henriques JF, Bellini-Pereira SA. Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta-analysis. J Esthet Restor Dent. 2021;33(3):446-457. https://doi.org/10.1111/jerd.12 695. Epub 2020 Dec 16. PMID: 33325589.

[13]. Younespour S, Yaghobee S, Aslroosta H, Moslemi N, Pourheydar E, Ghafary ES. Effectiveness of Different Modalities of Lip Repositioning Surgery for Management of Patients Complaining of Excessive Gingival Display: A Systematic Review and Meta-Analysis. Biomed Res Int. 2021;2021:9476013. https://doi.org/10.1155/2021/9476013. PMID: 34660 802; PMCID: PMC8516537.

[14]. Khan M, Akbar Z, Shan I. Rapid and Promising Technique to treat gummy smile – lip repositioning. J Coll Physicians Surgeons Pak. 2017;27(7):447-449.

[15]. McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM; and the PRISMA-DTA Group; Clifford T, Cohen JF, Deeks JJ, Gatsonis C, Hooft L, Hunt HA, Hyde CJ, Korevaar DA, Leeflang MMG, Macaskill P, Reitsma JB, Rodin R, Rutjes AWS, Salameh JP, Stevens A, Takwoingi Y, Tonelli M, Weeks L, Whiting P, Willis BH. Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement. JAMA. 2018 Jan 23;319(4):388-396.https://doi.org/10.1001/jama.2017.19163. Erratum in: JAMA. 2019 Nov 26;322(20):2026. PMID: 29362800.

[16]. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Lisy K, Mu P-F. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020.

[17]. Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A, Stephenson M, Aromataris E. Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth. 2020;18(10):2127-2133. https://doi.org/10.11124/JBISRIR-D-19-00099. PMID: 330381 25.

[18]. Jacobs PJ, Jacobs BP. Lip repositioning with reversible trial for the management of excessive gingival display: a case series. Int J Periodontics Restorative Dent. 2013;33(2):169-75. https://doi.org/10.11607/prd.1483. PMID: 23484172.

[19]. Ribeiro-Júnior NV, Campos TV, Rodrigues JG, Martins TM, Silva CO. Treatment of excessive gingival display using a modified lip repositioning technique. Int J Periodontics Restorative Dent. 2013;33(3):309-14. https://doi.org/10.11607/prd. 13 25. PMID: 23593624.

[20]. Silva CO, Ribeiro-Júnior NV, Campos TV, Rodrigues JG, Tatakis DN. Excessive gingival display: treatment by a modified lip repositioning technique. J Clin Periodontol. 2013;40(3):260-5. https://doi.org/10.1111/jcpe.12046. Epub 2012 Dec 20. PMID: 23278672.

[21]. Dayakar MM, Gupta S, Shivananda H. Lip repositioning: An alternative cosmetic treatment for gummy smile. J Indian Soc Periodontol. 2014;18(4):520-3. https://doi.org/10.4103/0972-124X.138751. PMID: 25210272; PMCID: PMC 4158599.

[22]. Jananni M, Sivaramakrishnan M, Libby TJ. Surgical correction of excessive gingival display in class I vertical maxillary excess: Mucosal strip technique. J Nat Sci Biol Med. 2014;5(2):494-8. https://doi.org/10.4103/0976-9668.136290. PMID: 25097447; PMCID: PMC4121947.

[23]. Ozturan S, Ay E, Sagir S. Case series of laser-assisted treatment of excessive gingival display: an alternative treatment. Photomed Laser Surg. 2014;32(9):517-23. https://doi.org/10.1089/pho.2014.3737. Epub 2014 Jul 23. PMID: 25054278.

[24]. Rao AG, Koganti VP, Prabhakar AK, Soni S. Modified lip repositioning: A surgical approach to treat the gummy smile. J Indian Soc Periodontol. 2015;19(3):356-9. https://doi.org/10.4103/0972-124X.152400. PMID: 26229285; PMCID: PMC4520129.

[25]. Alammar A, Heshmeh O, Mounajjed R, Goodson M, Hamadah O. A comparison between modified and conventional surgical techniques for surgical lip repositioning in the management of the gummy smile. J Esthet Restor Dent. 2018;30(6):523-531. https://doi.org/10.1111/jerd.12433. Epub 2018 Nov 9. PMID: 30412347.

[26]. Tawfik OK, Naiem SN, Tawfik LK, Yussif N, Meghil MM, Cutler CW, Darhous M, El-Nahass HE. Lip repositioning with or without myotomy: A randomized clinical trial. J Periodontol. 2018;89(7):815-823. https://doi.org/10.1002/JPER.17-0598 PMID: 30006937.

[27]. Bouguezzi A, Boudour OH, Sioud S, Hentati H, Selmi J. Mucosal coronally positioned flap technique for management of excessive gingival display. Pan Afr Med J. 2020; 36: 235. https://doi.org/10.11604/pamj.2020.36.235.22597. PMID:33708326; PMCID: PMC7908332.

[28]. Mateo E, Collins JR, Rivera H, Nart J. New Surgical Approach for Labial Stabilization: A Long-Term Follow-up Case Series. Int J Periodontics Restorative Dent. 2021;41(3):405-410. https://doi.org/10.11607/prd.4668. PMID: 34076637.

[29]. Çetin MB, Sezgin Y, Ak?nc? S, Bak?rarar B. Evaluating the Impacts of Some Etiologically Relevant Factors on Excessive Gingival Display. Int J Periodontics Restorative Dent. 2021;41(3):e73–e80. https://doi.org/10.11607/prd.5475. Epub 2021 Apr 5. PMID: 33819318.

[30]. Torabi A, Najafi B, Drew HJ, Cappetta EG. Lip Repositioning with Vestibular Shallowing Technique for Treatment of Excessive Gingival Display with Various Etiologies. Int J Periodontics Restorative Dent. 2018;38(Suppl):e1–e8. https://doi.org/10.11607/prd. 3120. Epub 2018 Mar 7. PMID: 29513771.

[31]. Andijani RI, Tatakis DN. Hypermobile upper lip is highly prevalent among patients seeking treatment for gummy smile. J Periodontol. 2019;90(3):256-262. https://doi.org/10.1002/JPER.18-0468. Epub 2018 Nov 21. PMID: 30367736.

[32]. Cengiz AF, Goymen M, Akcali C. Efficacy of botulinum toxin for treating a gummy smile. Am J Orthod Dentofacial Orthop. 2020 Jul;158(1):50-58. https://doi.org/10.1016/j.ajodo.2019.07.014. Epub 2020 May 12. PMID: 32414547.

[33]. Skaria J, Hegde N, George PP, Michael T, Sebastian J. Botulinum Toxin Type-A for the Treatment of Excessive Gingival Display on Smiling. J Contemp Dent Pract. 2020 Sep 1;21(9):1018-1021. PMID: 33568589.

[34]. Gibson MP, Tatakis DN. Treatment of Gummy Smile of Multifactorial Etiology: A Case Report. Clin Adv Periodontics. 2017;7(4):167-173. https://doi.org/10.1902/cap.2017.160074. PMID: 31539214

[35]. Arcuri T, da Costa MFP, Ribeiro IM, Barreto BD Júnior, Lyra eSilva JP. Labial repositioning using polymethylmethracylate (PMMA)-based cement for esthetic smile rehabilitation-A case report. Int J Surg Case Rep. 2018;49:194-204. https://doi.org/10.1016/j.ijscr.2018.07.008. Epub 2018 Jul 17. PMID: 30029078; PMCID: PMC6077168.

[36]. Faus-Matoses V, Faus-Matoses I, Jorques-Zafrilla A, Faus-Llácer VJ. Lip repositioning technique. A simple surgical procedure to improve the smile harmony. J Clin Exp Dent. 2018;10(4):e408-e412. https://doi.org/10.4317/jced.54721. PMID: 29750105; PMCID: PMC5937970.

[37]. Yun JBS, Luo M, Yin Y, Hui VLZ, Fang B, Han XL. Etiology-based treatment strategy for excessive gingival display: literature review. World J Surg Surgical Res. 2019;2(1103):1-5.

[38]. Vergara-Buenaventura A, Mayta-Tovalino F, Correa A, Breen E, Mendoza-Azpur G. Predictability in Lip Repositioning with Botulinum Toxin for Gummy Smile Treatment: A 3-Year Follow-up Case Series. Int J Periodontics Restorative Dent. 2020;40(5):703-709. https://doi.org/10.11607/prd.4645

Publicado

2023-06-26

Cómo citar

1.
Couto e Silva J, Guimarães Abreu L, Araújo Cunha F, Lopes Freire B, Esteves Lima RP. Eficacia del reposicionamiento de labios en el tratamiento de la exposición gingival excesiva: revisión sistemática y metanálisis. J Oral Res [Internet]. 26 de junio de 2023 [citado 21 de febrero de 2024];12(1):35-47. Disponible en: https://revistas.udec.cl/index.php/journal_of_oral_research/article/view/11280

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