Treatment of Excessive Gingival Display (Lip Repositioning and Z Plasty)

January 5, 2026 updated by: Leen somaf, Suez Canal University

Assessment of Modified Lip Repositioning Surgery and Z Plasty Frenectomy for Treatment of Excessive Gingival Display

evaluate clinically the postoperative outcomes of the Z plasty frenectomy technique in comparison to modified lip repositioning surgery

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Excessive gingival display is a cosmetic problem where it is usually managed by different approaches such as lip repositioning.

Aim: Is to evaluate clinically the postoperative outcomes of the Z plasty frenectomy technique in comparison to modified lip repositioning surgery Methodology: The clinical study will include 16 patients with gummy smile divided into two groups equally and randomly according to technique using www.randomizer.org.

Group 1: will be treated with conventional modified lip repositioning technique and the labial frenum will be left intact.

Group 2: will be treated with z plasty frenectomy. Clinical follow up will be at 1,3, 6 and 9 months.

Clinical evaluation will be done through using (VAS). It will be used to measure patient satisfaction through pain killer scale . - Likert scale to measure patient satisfaction - Periodontal probe will be used to measure the relapse. Also signs of infection will be recorded.

Study Type

Interventional

Enrollment (Actual)

16

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Ismailia, Egypt
        • Suez Canal University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Female patients aged 18 to 30 years
  • ASA physical status I or II
  • Presence of excessive gingival display (gummy smile)
  • Indication for surgical treatment of excessive gingival display
  • Willingness to participate and attend follow-up visits

Exclusion Criteria:

  • Poor oral hygiene
  • Patients with active acute infection
  • Patients with poor oral habits
  • Pregnant or lactating women
  • Heavy smokers
  • Alcohol or drug addicts

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: study group: z plasty frenectomy
Participants in the study group will be treated with Z- plasty frenectomy and will be followed up for 9 months
Procedure: z plasty frenectomy
Z-plasty frenectomy is a surgical procedure in which the frenum is released and rearranged using a Z-shaped incision. This technique helps improve tissue mobility and reduce tension. The procedure is performed under local anesthesia"
Other Names:
  • Z Plasty
Experimental: control group : modified lip repositioning
Participants in the control group will undergo modified lip repositioning with a follow-up period of 9 months.
Procedure: Modified lip repositioning
"Modified lip repositioning is a minimally invasive surgical technique used to reduce excessive gingival display. The procedure involves removing a small strip of mucosa and repositioning the upper lip to limit its upward movement during smiling. It is performed under local anesthesia ."
Other Names:
  • lip repositioning
  • gummy smile

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Gingival Display (mm)
Time Frame: Up to 9 months
Gingival display will be assessed in millimeters using standardized clinical photographs taken at maximum smile. Measurements will be performed using a periodontal probe to determine the vertical distance between the inferior border of the upper lip and the gingival margin of the maxillary central incisors. A reduction in gingival display indicates improvement, while an increase indicates relapse. Measurements will be recorded at baseline and during follow-up visits.
Up to 9 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain score
Time Frame: Up to 9 months
Postoperative pain will be assessed using a Visual Analog Scale (VAS) ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Lower scores indicate less pain.
Up to 9 months
Patient Satisfaction Score
Time Frame: Up to 9 months
Patient satisfaction will be evaluated using a numerical rating scale from 0 to 10, where 0 indicates complete dissatisfaction and 10 indicates maximum satisfaction. Higher scores indicate greater satisfaction.
Up to 9 months
Signs of infection
Time Frame: Up to 9 months
Postoperative infection will be assessed clinically based on the presence of signs such as redness, swelling, pain, discharge, or delayed healing at the surgical site. The outcome will be recorded as present or absent.
Up to 9 months
Surgical Time
Time Frame: During surgery
Surgical time will be measured in minutes from the initial incision to the completion of wound closure. Shorter surgical time indicates a more efficient procedure.
During surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Suez Canal University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 10, 2024

Primary Completion (Actual)

November 19, 2025

Study Completion (Actual)

November 30, 2025

Study Registration Dates

First Submitted

December 10, 2025

First Submitted That Met QC Criteria

January 5, 2026

First Posted (Estimated)

January 12, 2026

Study Record Updates

Last Update Posted (Estimated)

January 12, 2026

Last Update Submitted That Met QC Criteria

January 5, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2024/857

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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