Lip Repositioning with Crown Lengthening Gingival Depigmentation: A Case Report

This clinical report describes the successful use of lip repositioning technique for the reduction of excessive gingival display. A 34-year-old female patient reported with a chief complaint of gummy smile. The lip repositioning technique was performed under local anesthesia with the main objective of reducing gummy smile by limiting the retraction of elevator muscles (e.g. zygomaticus minor, levator anguli, orbicularis oris and levator labii superioris). The technique is fulfilled by removing a strip of mucosa from the maxillary buccal vestibule, creating a partial-thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display. A scalpel surgery was planned for depigmentation. The entire procedure was explained to the patient and written consent was obtained. A Bard Parker handle with a No.15 blade was used to remove the pigmented layer. When a crown lengthening procedure is planned to increase the length of the available tooth, the biological width needs to be considered and not encroached upon, as this may lead to periodontal breakdown.