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Reposicionamento labial cirúrgico (lipstat) no tratamento da exposição gengival excessiva : relato de caso clínico
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Abstract(s)
A procura pela estética do sorriso tornou-se um dos principais objetivos da Medicina dentária. Ao longo do tempo a estética do sorriso ganhou um papel crucial no quotidiano da população. O sorriso gengival é um dos problemas relatados pelos pacientes, uma vez que influencia as relações sociais, a autoestima e a confiança. Isso pode causar desarmonia no sorriso e constitui, cada vez mais, uma preocupação tanto para os doentes como para os médicos dentistas (Jananni, Sivaramakrishnan, & Libby, 2014).
A beleza do sorriso não é apenas determinada pela cor, forma e posição dos dentes, mas também pelas características do tecido gengival e da conformação dos lábios. O termo sorriso gengival refere-se a uma condição não patológica em que mais de 3 milímetros de tecido gengival são expostos durante o sorriso (Storrer, Valverde, Santos, & Deliberador, 2014) (Bhola et al., 2015).
Existem várias etiologias distintas para esta condição, tais como: erupção passiva alterada, crescimento vertical excessivo da maxila, extrusão dento-alveolar, lábio superior curto, hiperatividade do lábio superior, aumento gengival induzido por placa bacteriana ou medicamentos. Portanto, é essencial que o médico dentista realize um diagnóstico diferencial para aplicar a abordagem terapêutica adequada a cada caso em particular. Por vezes, não há apenas um fator etiológico, mas sim uma combinação de fatores e, nesses casos, é necessária uma abordagem multidisciplinar de tratamentos (Mantovani et al., 2016) (Sánchez, Gaud-Quintana, & Stern, 2017) (Bhola et al., 2015).
Quando a parte dentária está adequada, ou seja, há uma proporção estética entre a altura e a largura dos dentes; além disso o tecido gengival está saudável, sem crescimento induzido por qualquer fator; mas ainda existe a queixa do sorriso gengival, as causas relacionadas ao excesso vertical da maxila, extrusão dento-alveolar, lábio curto ou hiperativo, podem ser tratadas com o Reposicionamento Labial Cirúrgico (LipStat), sendo uma opção cirúrgica menos invasiva do que uma cirurgia ortognática (Bhola et al., 2015).
A exposição excessiva da gengiva, também conhecida como "sorriso gengival," pode ser tratada com sucesso através de várias abordagens cirúrgicas, que devem ser escolhidas com base na causa subjacente e nas características clínicas de cada caso. Nos últimos anos, temos assistido a uma expansão significativa na nossa compreensão das causas do sorriso gengival e das opções técnicas disponíveis para auxiliar os pacientes a alcançar o resultado estético desejado (Tatakis, D. N., & Silva, C. O. (2023).
A tipologia de trabalho que será desenvolvida na Tese de Mestrado consistirá numa revisão da literatura sobre o Reposicionamento Labial Cirúrgico (LipStat), com a descrição detalhada de um caso clínico que será tratado na Clínica Dentária Egas Moniz. Esta abordagem integrada permitirá uma análise aprofundada das aplicações práticas do LipStat na Medicina Dentária e fornecerá uma visão valiosa sobre sua eficácia clínica.
The search for smile aesthetics has become one of the main objectives of dentistry. Over time, smile aesthetics has gained a crucial role in the daily lives of the population. A gummy smile is one of the problems reported by patients, as it influences social relationships, self-esteem and confidence. This can cause disharmony in the smile and is increasingly a concern for both patients and dentists (Jananni, Sivaramakrishnan, & Libby, 2014). The beauty of a smile is not only determined by the color, shape and position of the teeth, but also by the characteristics of the gingival tissue and the conformation of the lips. The term Gummy Smile refers to a non-pathological condition in which more than 3 millimeters of gingival tissue are exposed during smiling (Storrer, Valverde, Santos, & Deliberador, 2014) (Bhola et al., 2015). There are several distinct etiologies for this condition, such as: altered passive eruption, excessive vertical growth of the maxilla, dentoalveolar extrusion, short upper lip, hyperactivity of the upper lip, gingival enlargement induced by orthodontics, bacterial plaque or medications. Therefore, it is essential that the dentist performs a differential diagnosis to apply the appropriate therapeutic approach to each particular case. Sometimes, there is not just one etiological factor, but rather a combination of factors and, in these cases, a multidisciplinary approach to treatments is necessary (Mantovani et al., 2016) (Sánchez, Gaud-Quintana, & Stern, 2017) (Bhola et al., 2015). When the dental part is adequate, that is, there is an aesthetic proportion between the height and width of the teeth; in addition, the gingival tissue is healthy, without growth induced by any factor; but there is still the complaint of a gummy smile, the causes related to vertical excess of the maxilla, dentoalveolar extrusion, short or hyperactive lip, can be treated with Surgical Lip Repositioning (LipStat), being a less invasive surgical option than orthognathic surgery (Bhola et al., 2015). Excessive gum exposure, also known as a "gummy smile," can be successfully treated through several surgical approaches, which should be chosen based on the underlying cause and the clinical characteristics of each case. In recent years, we have witnessed a significant expansion in our understanding of the causes of gummy smile and the technical options available to help patients achieve the desired aesthetic result (Tatakis, D. N., & Silva, C. O. (2023). The type of work that will be developed in the Master's Thesis will consist of a review of the literature on Surgical Lip Repositioning (LipStat), with a detailed description of a clinical case that will be treated at the Egas Moniz Dental Clinic. This integrated approach will allow an in-depth analysis of the practical applications of LipStat in Dentistry and will provide valuable insight into its clinical effectiveness.
The search for smile aesthetics has become one of the main objectives of dentistry. Over time, smile aesthetics has gained a crucial role in the daily lives of the population. A gummy smile is one of the problems reported by patients, as it influences social relationships, self-esteem and confidence. This can cause disharmony in the smile and is increasingly a concern for both patients and dentists (Jananni, Sivaramakrishnan, & Libby, 2014). The beauty of a smile is not only determined by the color, shape and position of the teeth, but also by the characteristics of the gingival tissue and the conformation of the lips. The term Gummy Smile refers to a non-pathological condition in which more than 3 millimeters of gingival tissue are exposed during smiling (Storrer, Valverde, Santos, & Deliberador, 2014) (Bhola et al., 2015). There are several distinct etiologies for this condition, such as: altered passive eruption, excessive vertical growth of the maxilla, dentoalveolar extrusion, short upper lip, hyperactivity of the upper lip, gingival enlargement induced by orthodontics, bacterial plaque or medications. Therefore, it is essential that the dentist performs a differential diagnosis to apply the appropriate therapeutic approach to each particular case. Sometimes, there is not just one etiological factor, but rather a combination of factors and, in these cases, a multidisciplinary approach to treatments is necessary (Mantovani et al., 2016) (Sánchez, Gaud-Quintana, & Stern, 2017) (Bhola et al., 2015). When the dental part is adequate, that is, there is an aesthetic proportion between the height and width of the teeth; in addition, the gingival tissue is healthy, without growth induced by any factor; but there is still the complaint of a gummy smile, the causes related to vertical excess of the maxilla, dentoalveolar extrusion, short or hyperactive lip, can be treated with Surgical Lip Repositioning (LipStat), being a less invasive surgical option than orthognathic surgery (Bhola et al., 2015). Excessive gum exposure, also known as a "gummy smile," can be successfully treated through several surgical approaches, which should be chosen based on the underlying cause and the clinical characteristics of each case. In recent years, we have witnessed a significant expansion in our understanding of the causes of gummy smile and the technical options available to help patients achieve the desired aesthetic result (Tatakis, D. N., & Silva, C. O. (2023). The type of work that will be developed in the Master's Thesis will consist of a review of the literature on Surgical Lip Repositioning (LipStat), with a detailed description of a clinical case that will be treated at the Egas Moniz Dental Clinic. This integrated approach will allow an in-depth analysis of the practical applications of LipStat in Dentistry and will provide valuable insight into its clinical effectiveness.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Sorriso gengival Exposição gengival Estética gengival Gengivoplastia