露龈笑

露龈笑，又称笑龈，是一种露出上唇下方牙龈的微笑方式。这是一种常见的临床疾病，可由牙齿异常萌出（延迟被动萌出）、上唇提肌功能亢进、上颚骨过度垂直生长、上颚前牙过度萌出或上述因素组合引起。 ^[1] ^[2]这种疾病有几种治疗方案，可以改善微笑曲线并减少牙龈暴露。 ^[3]

治疗

治疗方案包括牙齿矫正^[4]、牙龈切除术^[5]、肉毒杆菌毒素 A注射^[6] 、微自体脂肪移植 (MAFT) ^[7] 及勒福氏截骨术。

肉毒杆菌被认为是最安全且使用最广泛的注射剂之一。肉毒杆菌（ BTX-A ）可治疗露龈笑。肉毒杆菌丰唇术的效果平均可持续 6 个月。 ^[8]这种材料会注射到上唇过度活跃的肌肉中，减少嘴唇的向上移动幅度，从而使微笑时减少暴露牙龈。 ^[9]肉毒杆菌通常注射到鼻翼外侧的三块唇提肌中，即上唇提肌(LLS)、上唇提肌鼻翼肌(LLSAN) 和颧小肌(ZMi)。 ^[10]

参见

参考文献

^ Monaco A, Streni O, Marci MC, Marzo G, Gatto R, Giannoni M. Gummy smile: clinical parameters useful for diagnosis and therapeutical approach. The Journal of Clinical Pediatric Dentistry. 2004, 29 (1): 19–25. PMID 15554398. doi:10.17796/jcpd.29.1.y01l3r4m06q3k2x0.
^ Chandrasekharan D, Balaji SM. Intrusion of anterior teeth to improve smile esthetics. Journal of Maxillofacial and Oral Surgery. March 2010, 9 (1): 27–9. PMC 3453683  . PMID 23139562. doi:10.1007/s12663-010-0009-8.
^ Levine RA, McGuire M. The diagnosis and treatment of the gummy smile. Compendium of Continuing Education in Dentistry. August 1997, 18 (8): 757–62, 764; quiz 766. PMID 9533335.
^ Chandrasekharan D, Balaji SM. Intrusion of anterior teeth to improve smile esthetics. Journal of Maxillofacial and Oral Surgery. March 2010, 9 (1): 27–9. PMC 3453683  . PMID 23139562. doi:10.1007/s12663-010-0009-8.
^ Faus-Matoses V, Faus-Matoses I, Jorques-Zafrilla A, Faus-Llácer VJ. Lip repositioning technique. A simple surgical procedure to improve the smile harmony. Journal of Clinical and Experimental Dentistry. April 2018, 10 (4): e408–e412. PMC 5937970  . PMID 29750105. doi:10.4317/jced.54721.
^ Sucupira E, Abramovitz A. A simplified method for smile enhancement: botulinum toxin injection for gummy smile. Plastic and Reconstructive Surgery. September 2012, 130 (3): 726–8. PMID 22929256. S2CID 24821837. doi:10.1097/PRS.0b013e31825dc32f.
^ Huang SH, Huang YH, Lin YN, Lee SS, Chou CK, Lin TY, Takahashi H, Kuo YR, Lai CS, Lin SD, Lin TM. Micro-Autologous Fat Transplantation for Treating a Gummy Smile. Aesthetic Surgery Journal. March 2018, 38 (9): 925–937. PMC 6317576  . PMID 29566216. doi:10.1093/asj/sjy069.
^ Nayyar P, Kumar P, Nayyar PV, Singh A. BOTOX: Broadening the Horizon of Dentistry. Journal of Clinical and Diagnostic Research. December 2014, 8 (12): ZE25-9. PMC 4316364  . PMID 25654058. doi:10.7860/JCDR/2014/11624.5341.
^ Chagas, Taísa Figueiredo; Almeida, Natalia Valli de; Lisboa, Cinthia Oliveira; Ferreira, Daniele Masterson Tavares Pereira; Mattos, Claudia Trindade; Mucha, José Nelson. Duration of effectiveness of Botulinum toxin type A in excessive gingival display: a systematic review and meta-analysis. Brazilian Oral Research. 2018, 32: e30. ISSN 1807-3107. PMID 29742231. doi:10.1590/1807-3107bor-2018.vol32.0030  .
^ Hwang WS, Hur MS, Hu KS, Song WC, Koh KS, Baik HS, Kim ST, Kim HJ, Lee KJ. Surface anatomy of the lip elevator muscles for the treatment of gummy smile using botulinum toxin. The Angle Orthodontist. January 2009, 79 (1): 70–7. PMID 19123705. doi:10.2319/091407-437.1  .

[Monaco_2004-1] Monaco A, Streni O, Marci MC, Marzo G, Gatto R, Giannoni M. Gummy smile: clinical parameters useful for diagnosis and therapeutical approach. The Journal of Clinical Pediatric Dentistry. 2004, 29 (1): 19–25. PMID 15554398. doi:10.17796/jcpd.29.1.y01l3r4m06q3k2x0.

[2] Chandrasekharan D, Balaji SM. Intrusion of anterior teeth to improve smile esthetics. Journal of Maxillofacial and Oral Surgery. March 2010, 9 (1): 27–9. PMC 3453683  . PMID 23139562. doi:10.1007/s12663-010-0009-8.

[pmid9533335-3] Levine RA, McGuire M. The diagnosis and treatment of the gummy smile. Compendium of Continuing Education in Dentistry. August 1997, 18 (8): 757–62, 764; quiz 766. PMID 9533335.

[4] Chandrasekharan D, Balaji SM. Intrusion of anterior teeth to improve smile esthetics. Journal of Maxillofacial and Oral Surgery. March 2010, 9 (1): 27–9. PMC 3453683  . PMID 23139562. doi:10.1007/s12663-010-0009-8.

[5] Faus-Matoses V, Faus-Matoses I, Jorques-Zafrilla A, Faus-Llácer VJ. Lip repositioning technique. A simple surgical procedure to improve the smile harmony. Journal of Clinical and Experimental Dentistry. April 2018, 10 (4): e408–e412. PMC 5937970  . PMID 29750105. doi:10.4317/jced.54721.

[6] Sucupira E, Abramovitz A. A simplified method for smile enhancement: botulinum toxin injection for gummy smile. Plastic and Reconstructive Surgery. September 2012, 130 (3): 726–8. PMID 22929256. S2CID 24821837. doi:10.1097/PRS.0b013e31825dc32f.

[7] Huang SH, Huang YH, Lin YN, Lee SS, Chou CK, Lin TY, Takahashi H, Kuo YR, Lai CS, Lin SD, Lin TM. Micro-Autologous Fat Transplantation for Treating a Gummy Smile. Aesthetic Surgery Journal. March 2018, 38 (9): 925–937. PMC 6317576  . PMID 29566216. doi:10.1093/asj/sjy069.

[8] Nayyar P, Kumar P, Nayyar PV, Singh A. BOTOX: Broadening the Horizon of Dentistry. Journal of Clinical and Diagnostic Research. December 2014, 8 (12): ZE25-9. PMC 4316364  . PMID 25654058. doi:10.7860/JCDR/2014/11624.5341.

[9] Chagas, Taísa Figueiredo; Almeida, Natalia Valli de; Lisboa, Cinthia Oliveira; Ferreira, Daniele Masterson Tavares Pereira; Mattos, Claudia Trindade; Mucha, José Nelson. Duration of effectiveness of Botulinum toxin type A in excessive gingival display: a systematic review and meta-analysis. Brazilian Oral Research. 2018, 32: e30. ISSN 1807-3107. PMID 29742231. doi:10.1590/1807-3107bor-2018.vol32.0030  .

[10] Hwang WS, Hur MS, Hu KS, Song WC, Koh KS, Baik HS, Kim ST, Kim HJ, Lee KJ. Surface anatomy of the lip elevator muscles for the treatment of gummy smile using botulinum toxin. The Angle Orthodontist. January 2009, 79 (1): 70–7. PMID 19123705. doi:10.2319/091407-437.1  .

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