露齦笑

露齦笑，又稱笑齦，是一種露出上唇下方牙齦的微笑方式。這是一種常見的臨床疾病，可由牙齒異常萌出（延遲被動萌出）、上唇提肌功能亢進、上顎骨過度垂直生長、上顎前牙過度萌出或上述因素組合引起。 ^[1] ^[2]這種疾病有幾種治療方案，可以改善微笑曲綫並減少牙齦暴露。 ^[3]

治療

治療方案包括牙齒矯正^[4]、牙齦切除術^[5]、肉毒桿菌毒素 A注射^[6] 、微自體脂肪移植 (MAFT) ^[7] 及勒福氏截骨術。

肉毒桿菌被認為是最安全且使用最廣泛的注射劑之一。肉毒桿菌（ BTX-A ）可治療露齦笑。肉毒桿菌豐唇術的效果平均可持續 6 個月。 ^[8]這種材料會注射到上唇過度活躍的肌肉中，減少嘴唇的向上移動幅度，從而使微笑時減少暴露牙齦。 ^[9]肉毒桿菌通常注射到鼻翼外側的三塊唇提肌中，即上唇提肌(LLS)、上唇提肌鼻翼肌(LLSAN) 和顴小肌(ZMi)。 ^[10]

參見

參考文獻

^ 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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