露龈笑

露龈笑，又稱笑齦，是一种微笑時露出上唇下方牙龈過度外露的面部特徵。这是一种常见的临床疾病，源於牙齿异常萌出（如延迟被动萌出）、上唇提肌功能亢进、上顎骨垂直方向過度發育、上顎前牙过度萌出，或是上述因素的綜合作用。 ^[1] ^[2]目前臨床上有數種治療方案可以改善微笑曲綫并减少牙龈暴露量。 ^[3]

治疗

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

在眾多療法中，肉毒杆菌被視為最安全且應用最廣泛的注射製劑。其作用機制是將藥物精準注射至上唇過度活躍的提肌群（包含上唇提肌LLS、上唇鼻翼提肌LLSAN與顴小肌ZMi），通過抑制肌肉收縮強度來減少微笑時上唇上提幅度，從而降低牙齦暴露量。 ^[8]^[9]此療法除改善露齦笑外，同時具備豐唇效果，且效果平均可維持6個月 ^[10]

參見

参考文獻

^ 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.
^ 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 .
^ 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 [2024-07-27]. ISSN 1807-3107. PMID 29742231. doi:10.1590/1807-3107bor-2018.vol32.0030 . （原始内容存档于2024-09-11）.
^ 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.

[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] 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 .

[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 [2024-07-27]. ISSN 1807-3107. PMID 29742231. doi:10.1590/1807-3107bor-2018.vol32.0030 . （原始内容存档于2024-09-11）.

[10] 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.

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