Management of Excessive Gingival Display
Summary
Excessive gingival display, commonly known as a “gummy smile”, arises when more than 3 mm of gingival tissue is visible upon smiling. The condition has multifactorial aetiology, including vertical maxillary excess, altered passive eruption, dentoalveolar extrusion and hyperactivity of the upper lip elevator muscles. Its management demands a tailored, multidisciplinary approach that balances aesthetic expectations with functional outcomes. Orthodontic intrusion and orthognathic surgery address skeletal discrepancies, while periodontal plastic surgery and crown lengthening correct gingival margin position and tooth proportion. Minimally invasive techniques such as lip repositioning surgery and botulinum toxin type A injections offer conservative alternatives, reducing gingival exposure by limiting lip elevation. Emerging strategies integrate digital workflows for precise planning and guide fabrication, and employ adjunctive materials or suturing modifications to enhance surgical stability. Long-term success hinges on accurate diagnosis, alignment of lip and tooth anatomy, patient satisfaction and careful postoperative monitoring.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Management of Excessive Gingival Display publication trend
The graph below shows the total number of articles in management of excessive gingival display across all publications each year (not limited to Nature Index journals).
Technical terms
Excessive Gingival Display: Exposure of more than 3 mm of gum on smiling, impacting aesthetic harmony.
Altered Passive Eruption: Failure of gingival tissues to recede to the cementoenamel junction after tooth eruption.
Lip Repositioning Surgery: A procedure that restricts upper lip elevation by removing a strip of mucosa and anchoring the lip at a lower position.
Periosteal Sutures: Sutures placed to secure soft tissue to the underlying bone, enhancing postoperative stability.
Digital Workflow: Use of computer-aided design and fabrication tools for virtual treatment planning and guide production.
Botulinum Toxin Type A: A neuromodulator injected to reduce hyperactivity of the upper lip elevator muscles.
Orthognathic Surgery: Surgical repositioning of jaw bones to correct skeletal discrepancies contributing to gummy smile.
References
- A Modified Approach in Lip Repositioning Surgery for Excessive Gingival Display to Minimize Post-Surgical Relapse: A Randomized Controlled Clinical Trial. Diagnostics (2023).
- Duration of effectiveness of Botulinum toxin type A in excessive gingival display: a systematic review and meta-analysis. Brazilian Oral Research (2018).
- Periodontal Plastic Surgery to Improve Aesthetics in Patients with Altered Passive Eruption/Gummy Smile: A Case Series Study. International Journal of Dentistry (2012).
- Guided Periodontal Surgery: Association of Digital Workflow and Piezosurgery for the Correction of a Gummy Smile. Case Reports in Dentistry (2020).
- Digital Smile Makeover: A Multidisciplinary Team Approach. European Journal of Dentistry (2023).
- A Lip Repositioning Technique Using Polyester Threads for Gummy Smile Treatment. International Journal of Dentistry (2022).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.