Background. The prevalence of excessive gingival display is reported to be 7% in males and 14% in females, which results in an unaesthetic smile. In general, the underlying etiology dictates the primary treatment approach. Such techniques include crown lengthening procedures, orthognathic surgery, the use of botulinum toxin A, and lip REPOSITIONING. Methods. Rubenstein and Kostianovsky in 1973 proposed lip REPOSITIONING as a conservative surgical technique that offers a less invasive approach to correct excessive gingival display. Since the introduction of the technique, several modifications have been introduced, most prominently include muscle detachment, frenulum sparing, and the use of lasers. Results. Complications reported in the literature include scar formation, a feeling of discomfort, numbness, and difficulty in upper lip movement. Severe vertical maxillary excess (> 8 mm) and the presence of a minimal zone of the attached gingiva, which can create difficulties in flap design, stabilization, and suturing, may jeopardize its application. Conclusions. As it has been gaining popularity, there is a need for a decision-making protocol due to limited well-designed literature elucidating the detailed approach and long-term outcomes.

Drug development can be time-consuming and expensive. Recent estimates suggest that, on average, it takes 10 years and at least $1 billion to bring a drug to market. Since last decade, 30-40% of drugs or biologics that were approved or launched for the first time in the US were either drugs repositioned for new indications, reformulations or new combinations of existing drugs. This is the lifecycle business with REPOSITIONING as a major contributor, and it is rarely given much attention outside of its practitioners. . .

The overall rate of atrial pacing lead dislodgement is estimated to be about 3%. These leads are generally repositioned via a second operation through opening the pacemaker pocket. Some operators have introduced percutaneous techniques using snare system or deflectable catheters for this purpose. In this article we present our experience with five cases of percutaneous lead REPOSITIONING. Three cases were performed using deflectable ablation catheters and in two cases we used a specially designed urologic basket. The procedural success rate was 100% at the beginning but the long term success rate was 60%.

Background. By growing desire of people to have “ perfect smile” , the demands for esthetic surgeries have increased. The position of lips, the condition of oral tissues and gingival outlines are factors affecting smile. Excess gingival display (EGD) is a smile showing more than 1/5-2 mm of gingiva. One of the usual approaches for treatment of EGD is lip REPOSITIONING. Several Modifications have been introduced for lip REPOSITIONING including: 1) Lip REPOSITIONING with myotomy 2) Lip REPOSITIONING without myotomy, and 3) frenum sparing. The aim of this poster is to review the stability and benefits of different techniques. Methods. A search with key words of “ excessive gingival display” , “ gummy smile” , “ lip REPOSITIONING” , “ laser surgery” , “ gingiva” , and “ myotomy” was performed on Medline, Scopus, Cochrane, and Springer. Relevant articles up to March 2019 were evaluated. Results. Lip REPOSITIONING with myotomy and muscle severance offered a more stable and an improved reduction in EGD compared to the methods without myotomy. Swelling and pain were comparable either. The results about lip REPOSITIONING with frenum sparing and laser were considerable either. Conclusions. Lip REPOSITIONING with several modifications is an acceptable approach to treat EGD. Lip REPOSITIONING shows a stable result after 6 to 12 months according to researches. It also contains less invasive way compared to orthognothic surgery.

For many years oral esthetic problems treated by dentists were limited to those involving the teeth without giving consideration to the gingiva. However, today it is well established that these structures should be in balance to appear esthetically pleasing. More than 3mm gingival show during smiling is considered as ‘ excessive gingival display’ also known as “ gummy smile” , which is not attractive. The current case series, presents three patients with gummy smile managed by lip REPOSITIONING surgery, each with 1 year follow up. Our objective was to introduce lip REPOSITIONING as a successful treatment modality to decrease gingival show using a simple and conservative surgical approach.