The aim was to assess the craniofacial characteristics of patients with a gummy smile, classifying the types of gummy smile in a population of adolescents, and then estimating the impact of orthodontic treatment with premolar extractions on the persistence of this type of smile. Based on 64 complete orthodontic records, a cross-sectional study was conducted over a period of 4 months in the orthodontics department of Casablanca. The study used the analysis of various craniofacial parameters from data collected from clinical records. Estimation of the gingival smile was performed according to the four types proposed by Wu et al. 2010. Data analysis was carried out using Jamovi 2021 software (Version 1.8). The chi2 test was performed to compare the data and a p-value of 0.05 was considered statistically significant. The gingival smile was present in 35.9% of the adolescent population. Girls were more likely to have a gummy smile than boys, however the statistical correlation was not significant. Facial convexity was most common in patients with a gingival smile. Resting stomion was most common in the gummy smile population. Increased overjet and overbite were most common in the gummy smile population. Skeletal class II and hyperdivergent facies were the most frequent in adolescents with a gingival smile. In conclusion, a predominance of the female gender with a sex ratio of 2:1 characterized the adolescents with a gummy smile. The majority of the cases presented a type I gingival smile defined by a continuous gingival band covering the entire smile arch, followed by type IV defined by a significant gingival exposure only in the anterior sector.
Cite this paper
Bourzgui, F. , Khamlich, K. , Moustahfid, S. and Serhier, Z. (2024). Gummy Smile and Craniofacial Typologies in an Adolescent Population. Open Access Library Journal, 11, e1137. doi: http://dx.doi.org/10.4236/oalib.1111137.
Reynders, R.M. and Isaia, L. (2019) Social Media and Orthodontics: A Commentary on a Systematic Review. Evidence-Based Dentistry, 20, 123-126.
https://doi.org/10.1038/s41432-019-0060-3
Gasparello, G.G., Júnior, S.L.M., Hartmann, G.C., Meira, T.M., Camargo, E.S., Pithon, M.M. and Tanaka, O. (2022) The Influence of Malocclusion on Social Aspects in Adults: Study via Eye Tracking Technology and Questionnaire. Progress in Orthodontics, 23, Article No. 4. https://doi.org/10.1186/s40510-022-00399-3
Hunt, O., Johnston, C., Hepper, P., Burden, D. and Stevenson, M. (2002) The Influence of Maxillary Gingival Exposure on Dental Attractiveness Ratings. European Journal of Orthodontics, 24, 199-204. https://doi.org/10.1093/ejo/24.2.199
Dym, H. and Pierre, R. (2020) Diagnosis and Treatment Approaches to a “Gummy Smile”. Dental Clinics of North America, 64, 341-349.
https://doi.org/10.1016/j.cden.2019.12.003
Wu, H., Lin, J., Zhou, L. and Bai, D. (2010) Classification and Craniofacial Features of Gummy Smile in Adolescents. Journal of Craniofacial Surgery, 21, 1474-1479.
https://doi.org/10.1097/SCS.0b013e3181edc627
Fiorillo, L. (2022) Fi-Index: A New Method to Evaluate Authors Hirsch-Index Reliability. Publishing Research Quarterly, 38, 465-474.
https://doi.org/10.1007/s12109-022-09892-3
Fiorillo, L. and Cicciù, M. (2022) The Use of Fi-Index Tool to Assess Per-Manuscript Self-Citations. Publishing Research Quarterly, 38, 684-692.
https://doi.org/10.1007/s12109-022-09920-2
Khan, F. and Abbas, M. (2014) Frequency of Gingival Display during Smiling and Comparison of Biometric Measurements in Subjects with and without Gingival Display. Journal of College of Physicians and Surgeons Pakistan, 24, 503-507.
Tjan, A.H., Miller, G.D. and The, J.G. (1984) Some Esthetic Factors in a Smile. Journal of Prosthetic Dentistry, 51, 24-28.
https://doi.org/10.1016/S0022-3913(84)80097-9
Kapagiannidis, D., Kontonasaki, E., Bikos, P. and Koidis, P. (2005) Teeth and Gingival Display in the Premolar Area during Smiling in Relation to Gender and Age. Journal of Oral Rehabilitation, 32, 830-837.
https://doi.org/10.1111/j.1365-2842.2005.01517.x
Al-Jabrah, O., Al-Shammout, R., El-Naji, W., Al-Ajarmeh, M. and Al-Quran, A.H. (2010) Gender Differences in the Amount of Gingival Display during Smiling Using Two Intraoral Dental Biometric Measurements. Journal of Prosthodontics, 19, 286-293. https://doi.org/10.1111/j.1532-849X.2009.00562.x
Miron, H., Calderon, S. and Allon, D. (2012) Upper Lip Changes and Gingival Exposure on Smiling: Vertical Dimension Analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 141, 87-93.
https://doi.org/10.1016/j.ajodo.2011.07.017
Liang, L.Z., Hu, W.J., Zhang, Y.L. and Chung, K.H. (2013) Analysis of Dynamic Smile and Upper Lip Curvature in Young Chinese. International Journal of Oral Science, 5, 49-53. https://doi.org/10.1038/ijos.2013.17
Liebart, M.F., Fouque-Deruelle, C., Santini, A., Dillier, F.-L., Monnet-Corti, V., Glise, J.M. and Borghetti, A. (2004) Smile Line and Periodontium Visibility.
Saga, A.Y., Araújo, E.A., Antelo, O.M., Meira, T.M. and Tanaka, O.M. (2020) Nonsurgical Treatment of Skeletal Maxillary Protrusion with Gummy Smile Using Headgear for Growth Control, Mini-Implants as Anchorage for Maxillary Incisor Intrusion, and Premolar Extractions for Incisor Retraction. American Journal of Orthodontics and Dentofacial Orthopedics, 157, 245-258.
https://doi.org/10.1016/j.ajodo.2018.09.021
Mahaini, L. (2014) Craniofacial Features of Gummy Smile in a Syrian Adult Population. Jordan Medical Journal, 48, 181-188. https://doi.org/10.12816/0025885
Monaco, A., Streni, O., Marci, M.C., Marzo, G., Gatto, R. and Giannoni, M. (2004) Gummy Smile: Clinical Parameters Useful for Diagnosis and Therapeutical Approach. Journal of Clinical Pediatric Dentistry, 29, 19-25.
https://doi.org/10.17796/jcpd.29.1.y01l3r4m06q3k2x0
Khan, F. and Abbas, M. (2014) The Mean Visible Labial Length of Maxillary and Mandibular Anterior Teeth at Rest. Journal of College of Physicians and Surgeons Pakistan, 24, 931-934.
Barbosa, D., Bernal, L., Zapata, O., Agudelo-Suárez, A., Angel, L., Estrada, F., et al. (2016) Influence of Facial and Occlusal Characteristics on Gummy Smile in Children: A Case-Control Study. Brazilian Research in Pediatric Dentistry and Integrated Clinic, 16, 25-34.
Li, H., Cao, T., Zhou, H. and Hou, Y. (2019) Lip Position Analysis of Young Women with Different Skeletal Patterns during Posed Smiling Using 3-Dimensional Stereophotogrammetry. American Journal of Orthodontics and Dentofacial Orthopedics, 155, 64-70. https://doi.org/10.1016/j.ajodo.2018.03.014
Hosseinzadeh-Nik, T., Yazdani-Damavandi, L. and Kharazi-Fard, M. (2005) The Correlation of Smile Line with the Vertical Cephalometric Parameters of Anterior Facial Height. Frontiers in Dentistry, 2, 21-28.
Kaku, M., Kojima, S., Sumi, H., Koseki, H., Abedini, S., Motokawa, M., Fujita, T., Ohtani, J., Kawata, T. and Tanne, K. (2012) Gummy Smile and Facial Profile Correction Using Miniscrew Anchorage. The Angle Orthodontist, 82, 170-177.
https://doi.org/10.2319/020711-86.1
Khan, M., Kazmi, S.M.R., Khan, F.R., et al. (2020) Analysis of Different Characteristics of Smile. BDJ Open, 6, Article No. 6. https://doi.org/10.1038/s41405-020-0032-x
