Our Summary

This research paper looked at the effect of orthognathic surgery (a type of jaw surgery) on treating a ‘gingival smile’, which is when too much gum shows when a person smiles. This is generally considered unattractive and can be caused by various factors, including the upper jaw growing too much. The researchers reviewed previous studies on this topic, of which 19 met their criteria for inclusion.

The studies showed that the upper jaw was moved upwards by 2-10mm in surgery, but this didn’t seem to be related to how much gum was showing to begin with. The paper concluded that orthognathic surgery isn’t the first choice of treatment for a gingival smile, but it could be a good option for patients who also have other conditions that could be improved by this surgery.

FAQs

  1. What is orthognathic surgery and what conditions can it treat?
  2. How can orthognathic surgery impact a ‘gingival smile’?
  3. Why isn’t orthognathic surgery considered the first choice of treatment for a gingival smile?

Doctor’s Tip

A doctor might tell a patient considering orthognathic surgery for a gingival smile that while the surgery can move the upper jaw upwards, it may not directly impact how much gum is showing when they smile. It is important to consider other factors and potential benefits of the surgery before making a decision. It’s recommended to discuss all options and potential outcomes with your healthcare provider before proceeding with any surgical intervention.

Suitable For

Patients who are typically recommended for orthognathic surgery include those with:

  1. Severe malocclusion (misalignment of the teeth)
  2. Facial asymmetry
  3. Difficulty chewing or speaking
  4. Breathing problems due to jaw structure
  5. Temporomandibular joint (TMJ) disorders
  6. Sleep apnea
  7. Aesthetic concerns such as a protruding or receding jaw
  8. Inability to close the lips comfortably
  9. Jaw pain or discomfort

It is important for patients to undergo a thorough evaluation by a qualified oral and maxillofacial surgeon to determine if orthognathic surgery is the best treatment option for their specific condition.

Timeline

Before orthognathic surgery:

  • Patient undergoes initial consultation with a maxillofacial surgeon to determine if they are a candidate for surgery.
  • Patient may undergo orthodontic treatment to prepare the teeth for surgery.
  • Patient undergoes pre-operative testing and evaluations to ensure they are healthy enough for surgery.
  • Patient discusses the goals and expectations of surgery with their surgeon.

During orthognathic surgery:

  • Surgeon performs the necessary procedures to reposition the upper and/or lower jaw to correct the alignment.
  • Surgery is typically done under general anesthesia and can take several hours to complete.
  • Patient may stay in the hospital for monitoring and pain management following the surgery.

After orthognathic surgery:

  • Patient will experience swelling, bruising, and discomfort in the days following surgery.
  • Patient will need to follow a soft diet for several weeks to allow the jaw to heal.
  • Patient will attend follow-up appointments with their surgeon to monitor the healing process.
  • Patient may undergo orthodontic treatment post-surgery to fine-tune the alignment of the teeth.
  • Patient will gradually resume normal activities and see improvements in their bite and facial appearance over time.

What to Ask Your Doctor

Some questions a patient should ask their doctor about orthognathic surgery for a gingival smile may include:

  1. What specific jaw movements will be made during the surgery to address my gingival smile?
  2. What are the potential risks and complications associated with orthognathic surgery for this specific issue?
  3. How long is the recovery process expected to be, and what can I expect in terms of pain and discomfort?
  4. Will I need to wear braces before or after the surgery, and for how long?
  5. Are there any alternative treatments or procedures that could address my gingival smile?
  6. How successful is orthognathic surgery in treating a gingival smile, and what are the expected outcomes?
  7. Will I need to follow a special diet or oral care routine during the recovery period?
  8. What is the experience and success rate of the surgeon performing the orthognathic surgery?
  9. How long will the results of the surgery last, and are there any long-term effects to consider?
  10. What is the overall cost of the surgery, and will my insurance cover any part of it?

Reference

Authors: Tomaz AFG, Marinho LCN, de Aquino Martins ARL, Lins RDAU, de Vasconcelos Gurgel BC. Journal: Oral Maxillofac Surg. 2020 Sep;24(3):283-288. doi: 10.1007/s10006-020-00857-4. Epub 2020 Jun 7. PMID: 32506335