Gummy smile: clinical parameters useful for diagnosis and therapeutical approach

2005 ◽  
Vol 29 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Annalisa Monaco ◽  
Oriana Streni ◽  
Maria Chiara Marci ◽  
Giuseppe Marzo ◽  
Roberto Gatto ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Careful Analysis ◽  
Verbal Communication ◽  
Clinical Parameters ◽  
Upper Lip ◽  
Correct Treatment ◽  
Dental Eruption ◽  
The Subject ◽  
Mixed Nature ◽  
Gummy Smile

In the analysis of the characteristics of a pleasant smile, a gummy smile has negative components, which most affect the esthetics of non-verbal communication. For this purpose a proposed classification based upon etiopathogenetic criteria as useful indications for a therapeutical approach is given.The nature of a high smile line can be: dento-gingival, connected to an abnormal dental eruption, which is revealed by a short clinic crown; muscular, caused by an hyperactivity of the elevator muscle of the upper lip; dento-alveolar (skeletal), due to an excessive protuberance or vertical growth of the jawbone (maxillary); lastly, a mixed nature, in the presence of more than one of the above described factors.The diagnosis of gummy smile must be precocious and based, with reference to specific parameters, upon a careful analysis of the etiopathogenetic factors and the degree of seriousness of the alteration. A correct treatment plan must contemplate the possibility of an orthognatodontic, orthopedic and/or surgical therapeutic resolution considering the seriousness and complexity of the gums exposures (high smile line) in connection with the age of the subject.

scholarly journals Botox in periodontics - Exploring new avenues

2021 ◽  
Vol 76 (2) ◽  
pp. 78-83
Author(s):  
Manchala S Reddy ◽  
Shishir R Shetty ◽  
Raghavendra M Shetty ◽  
Venkataramana Vannala ◽  
Shakeel S Khazi ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Accurate Diagnosis ◽  
Point Of View ◽  
Gingival Hyperplasia ◽  
Recent Past ◽  
Upper Lip ◽  
Facial Aesthetics ◽  
Correct Treatment ◽  
Surgical Methods ◽  
Gummy Smile

From a periodontal point of view, various factors contribute to facial aesthetics. In the recent past, studies have revealed that excessive gingival display is a factor that influences an individual’ smile line. Some literature exists to support that more than excessive gingival display of more than 3mm is considered unaesthetic and termed a ‘gummy smile’ (GS). The prevalence of 'gummy smile’ has been 10% and to be more common in females. Gingival hyperplasia altered passive eruption, vertical maxillary excess, and upper-lip hypermobility can all result in excessive gingival display when a patient smile.To select the correct treatment protocol, accurate diagnosis is essential. Various techniques have been used to treat gummy smile which includes surgical and non-surgical methods. Recently a non-surgical method using Botulinum toxin gained popularity considering that the method is minimally invasive.

Aesthetic Crown Lengthening for Gummy Smile Treatment Related to Altered Passive Eruption: A Case Report

2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono
Keyword(s):  
Case Report ◽  
Treatment Plan ◽  
Patient Treatment ◽  
Treatment Results ◽  
Dental Hospital ◽  
Proper Diagnosis ◽  
The Aesthetic ◽  
Smile Aesthetics ◽  
Crown Lengthening ◽  
Gummy Smile

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.

Le potentiel théâtral chez David Foenkinos. Analyse du roman, du scénario et du film La Délicatesse

2020 ◽  
Vol 65 (2) ◽  
pp. 297-319
Author(s):  
Aluaș Alina
Keyword(s):  
Text Processing ◽  
Careful Analysis ◽  
The Novel ◽  
Work Analysis ◽  
Personal Myth ◽  
The Subject

"The Theatrical Potential in David Foenkinos’ Work. Analysis of the Novel, the Scenario and the Film “La Délicatesse”. Our interest, especially when it comes to the subject of literature, is to show the manner in which the text processing done by the author (script writer/director) brings to light the guidelines of the novelistic text’s semantics, which under careful analysis reveals a kind of personal myth of the novelist. The skewed, syncopated, interrupted writing which disrupts the chronotope serves the needs of the script as well as the director’s selective vision. Unconsciously, the novel seems to follow the structure of the theatrical model. These traits can also be found in the cinematographic structure of the film. Keywords: love, eroticism, delicacy, theatricality, scenario, film. "

An Ayurvedic Visual Rehabilitation In Lebers Congenital Amaurosis - Prospective Case Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Vidhyasri M ◽  
Dr. S. M. Pasha
Keyword(s):  
Marked Improvement ◽  
Clinical Case ◽  
Treatment Plan ◽  
Visual Disability ◽  
Visual Rehabilitation ◽  
Potential Risks ◽  
The Subject ◽  
Slow Frequency

Introduction: This is the case report of child who was diagnosed with LCA reported with complaints of large-amplitude, slow-frequency, roving nystagmus, frequent tendency to press on his eyes, enopthalmos, with completely normal ophthalmoscopic examination with normal appearing optic nerve and retina and has a non recordable ERG; considering this condition under the lines of Vataja Nanatmaja Vyadhi treatment was structured to render effective visual rehabilitation which showed marked results. Methods: 4 years old male child who was diagnosed with lebers congenital amaurosis was brought by his parents to Eye OPD, GAMC, Bengaluru. The presentation of this case includes bibliographic review of the subject, presentation of a clinical case and description of the importance of Ayurvedic prespective of handling of these patients. Results: The child showed improvement in fixing for light and also nystagmus showed marked improvement and there were considerable behavioural changes observed. Discussion: It is important to deepen the environment of the disease to know the possible implications in Ayurvedic management, recognize the magnitude of visual disability that our patient presents for the establishment of the treatment plan and provide an integral care of excellence in an interdisciplinary way in favor of visual rehabilitation of our patients and also help to restore quality of life with no potential risks of side effects.

Botox A Injection Compared with Modified Lip Repositioning Surgery in the Treatment of Adult Patients with Gummy Smile Due to Hypermobile Upper Lip

2021 ◽  
Vol 5 (3) ◽  
pp. 142-153
Author(s):  
Zainab Abdel-Rhman Mohammed ◽  
Mohammed Abd Al-Alim Bushnak ◽  
Manal Yahia Foda ◽  
Dalia El Boghdady
Keyword(s):  
Adult Patients ◽  
Upper Lip ◽  
Gummy Smile

scholarly journals Importance of Diagnostic Waxing in Oral Rehabilitation: Case Report

2020 ◽  
Vol 22 (2) ◽  
pp. 146-150
Author(s):  
Mariana Lima da Costa Valente ◽  
Marcela Silva Costa ◽  
Paulo Marcos Bérgamo ◽  
Denise Tornavoi de Castro
Keyword(s):  
Quality Of Life ◽  
Treatment Plan ◽  
Dental Restoration ◽  
Oral Rehabilitation ◽  
Correct Treatment ◽  
Life Planning ◽  
End Of Treatment ◽  
Patient Reported ◽  
And Function

Currently, aesthetics, and especially the smile, adds considerable social value. In this way, patients suffering from dental loss wish that their rehabilitation be performed quickly and safely. The aim of oral rehabilitation is to restore masticatory, phonetic, aesthetic and quality of life to the patient. The diagnostic step is one of the most important and relevant steps in establishing a correct treatment plan and, in this way, it is possible to obtain excellent results. The present study aimed to demonstrate the importance of diagnostic waxing in oral rehabilitation. Patient sought treatment at the Dental Prosthesis Specialization Course at Odonto School, due to complaints associated with aesthetics and function. To improve their quality of life, planning of case was carried out through diagnostic waxing and a prosthetic solution was proposed. At the end of treatment and during the follow-up of the case, the patient reported satisfaction and significant improvement in quality of life. It can be concluded that the diagnostic waxing presents customized solutions offering, through a previous study, an effective clinical resolution to the patient. Keywords: Mouth Rehabilitation. Dental Restoration, Temporary. Dental Restoration, Temporary. Resumo Atualmente, a estética, e em especial o sorriso, agregam um valor social considerável. Dessa forma, ao sofrerem a perda dental, os pacientes desejam que sua reabilitação seja realizada de forma rápida e segura. A reabilitação oral tem como objetivo devolver ao paciente a eficiência mastigatória, fonética, estética e a qualidade de vida. A etapa diagnóstica constitui um dos passos mais importantes e relevantes no estabelecimento de um correto planejamento do tratamento e, desta forma, torna-se possível obter resultados de excelência. O presente estudo teve como objetivo demonstrar a importância do enceramento diagnóstico na reabilitação oral. Paciente procurou tratamento no Curso de Especialização em Prótese Dentária da Odonto School, devido a queixas associadas a estética e função. Para melhorar sua qualidade de vida, foi realizado o planejamento do caso por meio do enceramento diagnóstico e uma solução protética foi proposta. Ao final do tratamento e durante o acompanhamento do caso, a paciente relatou satisfação e melhora significativa na qualidade de vida. Pode-se concluir que o enceramento diagnóstico apresenta soluções personalizadas oferecendo, por meio de estudo prévio, uma resolução clínica efetiva ao paciente. Palavras-chave: Reabilitação Bucal. Restauração Dentária Temporária. Prótese Dentária Temporária.

scholarly journals Bimaxillary protrusion and gummy smile treated with clear aligners: Closing premolar extraction spaces with bone screw anchorage

2020 ◽  
Vol 10 ◽  
pp. 120-131
Author(s):  
Lexie Y Lin ◽  
Chris H Chang ◽  
W. Eugene Roberts
Keyword(s):  
Treatment Plan ◽  
Current Case ◽  
Anterior Crowding ◽  
Excellent Outcome ◽  
Premolar Extraction ◽  
Treatment Analysis ◽  
Anterior Segments ◽  
Clear Aligner ◽  
Bimaxillary Protrusion ◽  
Gummy Smile

Inadequate posterior anchorage is a serious limitation for aligner treatment involving extraction of four first premolars. Inappropriate axial inclinations may compromise intermaxillary occlusion and stability. OrthoBoneScrew® (OBS) anchorage is designed to augment the Invisalign® clear aligner G6 solution to produce more predictable outcomes as illustrated by the current case report. An 18-year-old female presented with two chief complains: (1) Protrusive, incompetent lips, and (2) excessive gingival exposure when smiling (“gummy smile”). Clinical evaluation revealed bimaxillary protrusion, hypermentalis activity, anterior crowding, and excessive anterior axial inclinations, particularly of the lower incisors (116°). The American Board of Orthodontic (ABO) discrepancy index (DI) was 21. The treatment plan was extraction of all four first premolars, and clear aligner (Invisalign®) therapy anchored with four OBSs: Infra-zygomatic crest (IZC), and between the roots of the upper central and lateral incisors (Incisal) bilaterally. Eighteen months of initial treatment with 45 aligners retracted and intruded the anterior segments in both arches by closing the extraction spaces with supplemental anchorage provided by IZC and Incisal OBSs. The final series of 20 refinement aligners achieved an excellent outcome as evidenced by an ABO cast-radiograph evaluation (CRE) score of 10, and a pink and white (P&W) dental esthetic score of 3. Post-treatment analysis revealed multiple opportunities for improvement. The patient was well satisfied with the final outcome.

scholarly journals Je dood vervelen of je te pletter amuseren?

1970 ◽  
Vol 69 ◽  
pp. 103-136
Author(s):  
Emmeline Gyselinck ◽  
Timothy Colleman
Keyword(s):  
Careful Analysis ◽  
Scant Attention ◽  
The Subject ◽  
Resultative Construction ◽  
Zoom In ◽  
The One ◽  
Shed Light

This paper focuses on the intensifying use of the fake reflexive resultative construction,as demonstrated in the example Hij lacht zich een breuk om die mop (tit. 'He laughs himselfa fracture because of that joke'). Although the literal use of the (English) fake reflexiveresultative construction has been the subject of several studies, scant attention hasbeen paid to the potential of this construction for conveying an intensifying meaning,though these intensifying uses show an intriguing mix of productivity and lexical idiosyncrasythat deserves careful analysis. This case study will zoom in on the use of theintensifying fake reflexive resultative construction in present-day Belgian and NetherlandicDutch. The analysis will reveal some discrepancies between two national variants ofDutch and shed light on the development of subschemas displaying various degrees ofproductivity on the one hand and the possible lexicalisation of strong combinations on theother.

Inverse Methods to Improve Accuracy of Water Content Estimates from Multi-offset GPR

2018 ◽  
Vol 23 (3) ◽  
pp. 349-361
Author(s):  
Andrew D. Parsekian
Keyword(s):  
Water Content ◽  
Careful Analysis ◽  
Subsurface Water ◽  
Geologic Materials ◽  
Improve Accuracy ◽  
The Subject ◽  
Interval Velocities ◽  
Ground Penetrating ◽  
Radar Wave ◽  
The Impact

Ground penetrating radar (GPR) is a powerful hydrogeophysical tool for estimating porosity and water content of geologic materials using radar wave velocities and appropriate petrophysical relations. In substrates with more than one layer of interest, surface-based multi-offset measurements require careful analysis to accurately retrieve physical properties for each layer. Frequently, Dix inversion is used to calculate interval velocities, however the assumptions and limitations of this approach are widely known. In particular for survey geometries and targets encountered with GPR, the assumptions inherent to Dix inversion are readily violated, and therefore inverse modeling is required to avoid velocity error. While the impact on velocity incurred by violating the assumptions of Dix inversion is well understood, the effects on water content estimates have not been widely reported and are therefore the subject of this work. In a subsurface representative of an unsaturated zone overlying an aquifer, error in excess of 50% in water content due to violating the assumptions of Dix inversion is demonstrated. Examples are shown using raytracing inversion to solve for subsurface water content structure that avoids the errors inherent to Dix inversion. These results are intended to underscore the importance of minimizing assumptions and using more correct physics when analyzing multi-offset GPR data, particularly due to the large potential errors that may be encountered if water content estimation is the main objective.

scholarly journals Combined Use of 3D Metric Survey and GPR for the Diagnosis of the Trapezophoros with Two Griffins Attacking a Doe of Ascoli Satriano (Foggia, Italy)

Geosciences ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 307
Author(s):  
Marilena Cozzolino ◽  
Andrea Di Meo ◽  
Vincenzo Gentile ◽  
Paolo Mauriello ◽  
Enza Zullo
Keyword(s):  
Cultural Heritage ◽  
Ground Penetrating Radar ◽  
Visual Inspection ◽  
Careful Analysis ◽  
Preventive Strategies ◽  
State Of Health ◽  
Noninvasive Techniques ◽  
Combined Use ◽  
The Subject ◽  
Ground Penetrating

Protection and conservation are not feasible without a deeper knowledge of the cultural heritage of the subject of intervention. A careful analysis of documentation, a detailed visual inspection of surfaces, and a systematic diagnosis of the inner properties are the basis for planning preventive strategies of restoration. Digital noninvasive techniques represent an advantageous tool with useful outputs to estimate the state of health of cultural heritage in order to minimize the progress of degradation. This paper deals with a 3D metric survey through photogrammetry and ground-penetrating radar (GPR) tests applied to the study of the trapezophoros with two griffins attacking a doe of Ascoli Satriano, a masterpiece of ancient art that needs to be protected. This work provided information on both visible and hidden defects, such as numerous cracks that affect the sculpture.

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