Orthosurgical Correction of Severe Vertical Maxillary Excess: Gummy Smile

Gummy smile which is commonly described as excessive gingival display in full smile has become a major esthetic concern for patients and healthcare providers in recent years. Because of the complex etiologic factors and severity of this orofacial deformity including skeletal, dentoalveolar, muscular, and gingival, it is essential that a differential diagnosis be established so that a relevant therapy can be selected from a wide range of treatment options. The complex etiologic factors of this dentofacial deformity necessitates coordina-tion between a team of health care providers, especially between orthodontist and maxil- lofacial surgeon, to improve diagnosis and treatment planning, accurately predict the outcome, and minimize orthosurgical complications. In this chapter, the author will pre- sent several clinical cases and briefly review available treatment modalities for excessive gingival display in full smile. Emphasis will be put on orthosurgical treatment of severe vertical maxillary excess as the optimal solution to restore facial balance and harmony, attractive smile, and patients ’ satisfaction.