{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:03:35Z","timestamp":1789473815841,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Excessive gingival display (EGD) is an esthetic concern\u00a0resulting in\u00a0a gummy\u00a0smile.\u00a0\u00a0EGD\u00a0affects\u00a0patients\u2019\u00a0self\u2010confidence with negative\u00a0emotional and psychosocial\u00a0impact.\u00a0The\u00a0amount of gingival display\u00a0is affected by different etiologies, including\u00a0skeletal,\u00a0muscular, or\u00a0dento\u2010alveolar factors. The treatment\u00a0generally addresses\u00a0the etiology and includes\u00a0surgical lip repositioning (LRP), esthetic crown\u00a0lengthening, or\u00a0orthognathic surgery.\u00a0Modified LRP (mLRP) reduces gingival display\u00a0with less morbidity compared to orthognathic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The current report highlights an 8\u2010year follow\u2010up of identical 27\u2010year\u2010old twin sisters with EGD.\u00a0The follow\u2010up showed partial relapse in the original LRP and was retreated using mLRP. Therefore, the twins were retreated using mLRP, which had\u00a0a lower\u00a0rate of recurrence and higher patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both patients\u00a0demonstrated\u00a0normal\u00a0healing with a balanced\u00a0dynamic smile and stable upper\u2010lip position without\u00a0EGD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>mLRP provided esthetic\u00a0results with reduction\u00a0in\u00a0gummy smiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Lip repositioning (LRP) surgery is a less invasive alternative to orthognathic surgery in treating gummy smile patients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Modified LRP may work better long\u2010term than the original approach in treating relapses.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>This case report discusses treatment for a gummy smile that can affect patients\u2019 confidence by compromising their smile. Identical twin sisters who originally had lip repositioning (LRP) surgery to reduce a gummy smile experienced a relapse after 8 years. The relapse was treated with modified LRP surgery, which shows greater stability and less relapse in reducing the gummy smile compared to conventional LRP surgery. The modified approach significantly reduced the amount of gum display in both sisters and stayed stable through 18 months of follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cap.70106","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:14:03Z","timestamp":1789470843000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modified lip repositioning to correct gummy smile: 8\u2010year follow\u2010up of identical twins"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7222-9479","authenticated-orcid":false,"given":"Minki","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Graduate Studies \u2013 Graduate Periodontics Program University of Detroit Mercy School of Dentistry Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5407-0073","authenticated-orcid":false,"given":"Joseph","family":"Samona","sequence":"additional","affiliation":[{"name":"Division of Graduate Studies \u2013 Graduate Periodontics Program University of Detroit Mercy School of Dentistry Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0303-4868","authenticated-orcid":false,"given":"Joshua","family":"Graham","sequence":"additional","affiliation":[{"name":"Division of Graduate Studies \u2013 Graduate Periodontics Program University of Detroit Mercy School of Dentistry Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Latorre","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Division of Graduate Studies \u2013 Graduate Periodontics Program University of Detroit Mercy School of Dentistry Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5088-7496","authenticated-orcid":false,"given":"Anthony L.","family":"Neely","sequence":"additional","affiliation":[{"name":"Division of Graduate Studies \u2013 Graduate Periodontics Program University of Detroit Mercy School of Dentistry Detroit Michigan USA"},{"name":"Private Practice,\u00a0Ann Arbor\u2013Sterling Heights  Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassam M.","family":"Kinaia","sequence":"additional","affiliation":[{"name":"Division of Graduate Studies \u2013 Graduate Periodontics Program University of Detroit Mercy School of Dentistry Detroit Michigan USA"},{"name":"Private Practice,\u00a0Ann Arbor\u2013Sterling Heights  Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2019.12.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.4465"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.120403"},{"issue":"6","key":"e_1_2_9_5_1","first-page":"368","article-title":"Esthetic periodontal considerations in orthodontic treatment: the management of excessive gingival display","volume":"69","author":"Foley TF","year":"2003","journal-title":"J Can Dent Assoc"},{"issue":"3","key":"e_1_2_9_6_1","first-page":"24","article-title":"Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult","volume":"70","author":"Coslet JG","year":"1977","journal-title":"Alpha Omegan"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100757.1996.tb00179.x"},{"issue":"8","key":"e_1_2_9_8_1","first-page":"757","article-title":"The diagnosis and treatment of the gummy smile","volume":"18","author":"Levine RA","year":"1997","journal-title":"Compend Contin Educ Dent"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2013.130145"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2007.04.033"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01570248"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1902\/cap.2017.170037"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.23\u20100291"},{"issue":"5","key":"e_1_2_9_14_1","first-page":"433","article-title":"Lip repositioning for reduction of excessive gingival display: a clinical report","volume":"26","author":"Rosenblatt A","year":"2006","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12046"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.100292"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u2010124X.138751"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12433"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12695"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17\u20100598"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.08.003"},{"issue":"1","key":"e_1_2_9_22_1","first-page":"17","article-title":"Smile line and periodontium visibility","volume":"1","author":"Li\u00e9bart MF","year":"2004","journal-title":"Periodontal Pract Today"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40510\u2010025\u201000599\u20107"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58091265"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9476013"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.4707"}],"container-title":["Clinical Advances in Periodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cap.70106","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cap.70106","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cap.70106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:14:04Z","timestamp":1789470844000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/cap.70106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":25,"alternative-id":["10.1002\/cap.70106"],"URL":"https:\/\/doi.org\/10.1002\/cap.70106","archive":["Portico"],"relation":{},"ISSN":["2573-8046","2163-0097"],"issn-type":[{"value":"2573-8046","type":"print"},{"value":"2163-0097","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"2026-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cap.70106"}}