Think twice before jaw surgery for gummy smiles

This forum is for discussions relating to oral surgery for orthodontics.

Moderator: bbsadmin

Post Reply
Message
Author
aghummel90
Posts: 14
Joined: Tue Sep 18, 2018 6:02 pm

Think twice before jaw surgery for gummy smiles

#1 Post by aghummel90 » Sun Oct 21, 2018 4:36 pm

The LeFort osteotomy can be used to treat a gummy smile, but aesthetic disappointment happens often, and that's because surgeons do not explain the gum display-tooth-display trade-off to patients. Let me explain: if you're going to show less gum, it will necessarily happen at the expense of maxillary incisor display (i.e., your upper teeth). So what happens often is that surgeons eliminate the gummy smile, but then the patient shows no upper teeth at rest. This looks bad. It's very aging. Except in extreme cases, it looks worse than a gummy smile and lots of teeth showing at rest. It happened to me, and now I'm in the process of seeking a revision.

There are alternatives. Botox, lip repositioning, orthodontics. These are good alternatives to orthognathic surgery in many cases. If you are set on treating a gummy smile with a LeFort, you must scrutinize your surgical plan down to the millimiter. Ask your surgeon how much incisor display you'll have at rest and have him defend that decision. And then ask yourself if that's the outcome you would be comfortable with. Know that as you age, your upper lip will lengthen, and your gummy smile won't be as gummy.

snapdresser
Posts: 899
Joined: Wed Feb 18, 2015 7:31 am

Re: Think twice before jaw surgery for gummy smiles

#2 Post by snapdresser » Wed Oct 31, 2018 6:33 am

A good surgeon should be able to find a middle ground where you still have 1-2mm gum showing, or at least should be able to make sure that you have several mm of your upper incisors showing post-op. I agree that it’s worth warning people about the potential for over-impaction tho!
No braces
1-piece LeFort I + BSSO + Sliding Genio on 10 JUNE 2015!
Image

Post Reply