lasers

Statement of the Problem: 

The retention of dental crowns plays a pivotal role in their long-term success and maintenance. According to the ongoing controversy about the effect of GLUMA desensitizer and diode laser on the retention of full metal crowns, this study seeks to investigate the effectiveness of two different methods in enhancing the bond strength of full-metal crowns.

This study was developed to compare the effect of 940nm diode laser and GLUMA desensitizer on the bond strength of full-metal crowns cemented by self-adhesive resin cement (RelyX U200).

In this experimental study, 30 sound permanent maxillary first premolars were prepared; a 0.5-0.7 mm chamfer finish line was prepared above the cementoenamel junction. The teeth were randomly divided into three groups: 1. control group (n=10, no treatment) 2. 940nm diode laser (N=10) 3. GLUMA desensitizer (N=10). All crowns were cemented with self-adhesive resin cement (RelyX U200), and the bond strength was measured by universal testing machine. Data were analyzed by ANOVA and Post HOC Tukey test in SPSS Ver:20.

Crown retention in the 940 nm diode laser group (166.86±34.25 N) was significantly lower than the GLUMA desensitizer group (318.59±56.31 N) (p< 0.05), but there was no significant difference with the control group (138.17±40.81). Crown retention in the GLUMA desensitizer group was significantly higher than the other groups (p< 0.05).

Results of this study showed that GLUMA desensitizer had a positive effect, and 940 nm diode laser had no effect on the retention of crowns cemented by self-adhesive resin cement.

Some previous studies have suggested that laser irradiation improves the bond strength of composite to dentin. This study aimed to assess the effect of 810 and 970 nm diode laser on microtensile Bond Strength (µTBS) of universal adhesives to dentin. 

In this in vitro, experimental study, the occlusal third of 54 extracted third molars was cut, and they were randomly divided into 9 groups (n=18). In groups 1-3, Tetric N-Bond Universal (TNB), G-Premio Bond (GPB), and Single Bond Universal (SBU) adhesives were applied, respectively and the teeth were built-up by applying three 1-mm thick composite increments. The same was performed for groups 4-6 and 7-9 with the difference that they underwent 810 and 970 nm diode laser irradiation (0.8 W, 20 s), respectively, prior to light curing. All the teeth were then sectioned into 1×1 mm blocks and their µTBS was measured. Data were analyzed by two-way ANOVA and Tukey test.

The interaction effect of type of bonding agent and laser irradiation on µTBS was not significant (p=0.79). There was a statistical difference between the bond strength of the adhesive systems used (p=0.009).

Laser irradiation of universal adhesives applied by the etch and rinse (E&R) technique using 810 and 970 nm diode laser (0.8 W, 20 s) prior to their polymerization did not increase their µTBS to dentin.

 This study aimed to assess the photobiomodulation effects of blue and red lasers on the proliferation and osteogenic differentiation of periodontal ligament mesenchymal stem cells (PDLMSCs).

 PDLMSCs were cultured and tested in 4 groups. The first two groups were exposed to 445 nm diode laser irradiation (200 mW, 6 and 12 J/cm2), and the third group was exposed to
660 nm diode laser irradiation (50 mW, 4 J/cm2). The fourth group was also considered as the
control group without irradiation. Cell viability/proliferation was assessed by MTT assay. RUNX2, alkaline phosphatase (ALP), collagen type 1 (col1), and osteocalcin (OCN) were evaluated by RTPCR, and Alizarin red was used to evaluate the colonization. The data were analyzed by means of one-way analysis of variance.

 The results of our study showed that cell survival/proliferation in the second group was significantly lower than that in the control group on days 1 and 7 (P<0.05). RT-PCR showed a significant increase in osteogenic genes in all three laser groups compared to the control group (P<0.05). All groups showed a significant increase in calcium content compared to the control group (P<0.05). ALP activity also confirmed the osteoblastic differentiation of cells in laser groups.

 445 nm and 660 nm lasers with the studied parameters showed positive effects on the proliferation and osteoblastic differentiation of PDLMSCs.

 Endodontic treatment of teeth with periapical lesions presents more clinical difficulty. Various lasers in several methods are used in endodontics, and most of them are utilized as an adjunctive protocol in order to reduce the bacterial load of the root canal system. Improved disinfection plays a crucial role in enhanced and accelerated healing of periapical lesions. This review aims to summarize studies assessing the effect of lasers on periapical lesion healing.

 PubMed/MEDLINE, Scopus, Embase, and Web of Science (ISI) online databases were searched, with no publication year or status restriction, for relevant articles on April 2023. Clinical studies evaluating the effect of laser application on the periapical lesion of patients using radiographic assessment were considered eligible for inclusion.

 Eight studies were included after carefully screening the obtained articles, first by their title and abstract and then by their full texts. Diode (4), Er, Cr: YSGG (3), and Nd: YAG (1) lasers were used with output powers that varied from 0.75 to 2 watts. Photodynamic therapy was employed in two studies, and in other studies, the root canal system was directly irradiated. Irradiation of the root canal system was adjunctive to standard preparation in all studies. The healing of the teeth treated with lasers was not inferior to those conventionally treated. In all of the included studies, laser application outperformed the standard cleaning and shaping protocol; however, this improved or faster healing was not statistically significant in most studies.

 Lasers might expedite and improve the healing process of periapical lesions. Since lasers enhance the quality of cleaning of the root canal system, it is hard to point out the exact mechanism of it. Further investigations are needed to realize the effectiveness of this treatment modality and to discover the underlying biological concepts.

 Many surgical procedures in soft tissue are performed using diode lasers. This study aimed to assess the temperature rise and pain following the use of 810 and 980 nm diode lasers for second-stage dental implant surgery.

 This clinical trial was conducted on 24 osseointegrated dental implants that were randomly divided into two groups of 810 nm and 980 nm diode lasers. The temperature rise in each group was measured right after uncovering by the laser and 15 minutes later by a thermocouple, compared with the baseline temperature of gingival tissue. The level of pain was also measured at 24 hours postoperatively by using a visual analog scale. Data were analyzed by ANOVA, Tukey’s test, and t test (alpha=0.05).

 Within-group comparisons by ANOVA showed a significant difference in tissue temperature between the three-time points in both groups (P<0.0001). Pairwise comparisons by Tukey’s test showed that the temperature at baseline (P<0.0001) and 15 seconds after uncovering was significantly lower than that immediately after uncovering in both groups (P<0.0001). The mean tissue temperature and the mean pain score in the 980 nm laser group were significantly higher than the corresponding values in the 810 nm laser group (P<0.05).

 According to the results, temperature rise in the use of the 980 nm laser was higher than the 810 nm laser. The use of 810 nm diode laser was associated with lower temperature rise and significantly lower pain score after 24 hours.

 The adhesion ability of mesenchymal stem cells can significantly affect their viability and is considered a prerequisite for cell therapy. The current study sought to evaluate the effect of fibroblast growth factor 2 (FGF2) and low-level laser therapy (LLLT), either individually or in conjunction, on the adhesion and proliferation of periodontal ligament stem cells (PDLSCs) when applied on the first day of cell seeding.

 The experimental groups of this study comprised a control group and different combinations of adjunctive FGF2 (50 ng/mL) and LLLT with an 808 nm diode laser in one (LLLT1) or two sessions (LLLT-2) of irradiation. The proliferation and adhesion of cells were evaluated by using the methylthiazolyl tetrazolium (MTT) assay and 4′,6-diamidino-2-phenylindole (DAPI) staining. All experiments were done in triplicates on the first, third, and fifth days after cell seeding. Two-way ANOVA and post hoc Tukey tests were used to analyze the data of the MTT assay. P<0.05 was considered statistically significant.

 One-day post-culture, only significant differences were found between the control group and the FGF2 (P=0.04) and FGF2+LLLT-2 application (P=0.04) groups. After three days post-cell culture, only a significantly higher proliferation rate was found in the control group than in the FGF2 group (P=0.01). After five days, the control group and LLLT-2 groups showed significantly higher amounts of proliferation compared to the other groups (P<0.05). DAPI staining qualitatively confirmed the results of the MTT assay.

 The LLLT can be applied to PDLSCs on the day of seeding without causing a notable decrease in their viability and adhesion. Conversely, the administration of FGF2 should be restricted on the seeding day and postponed to subsequent days as it may have adverse effects on their adhesion and proliferation.

 Dentin hypersensitivity (DH) is a prevalent unpleasant condition that might affect quality of life. Laser therapy is one of the non-invasive treatments for dentin hypersensitivity. The aim of this umbrella review was to assess the effect of lasers on the treatment of dentin hypersensitivity by analyzing the previously published systematic reviews and meta-analyses.

 Electronic databases (PubMed, Embase, Scopus, Cochrane, and ISI) were searched to identify relevant systematic reviews and meta-analyses based on the keyword search strategy. Two independent reviewers carried out the selection of studies, extraction of data, and assessment of methodological quality. The actual overlap of primary studies was measured through the visual tool known as the citation matrix and three indices of % overlaps, covered area (CA), and corrected covered area (CCA). The reviews were appraised for methodological quality through A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2, and the risk of bias was evaluated using the Risk of Bias in Systematic Reviews (ROBIS) tool.

 Following the elimination of duplicates, a total of 2,768 articles were found, and of them, 9 systematic reviews met the inclusion criteria. Six of them included a meta-analysis as well. The actual overlap of primary studies was low. The AMSTAR 2 tool classified one systematic review as high quality, three as moderate quality, three as low quality, and the remaining two as critically low quality. The results of the included reviews generally showed that all types of lasers reduced dentin hypersensitivity compared to placebo/no treatment.

 Lasers are effective in treating dentin hypersensitivity.

The prevalence of enamel demineralization around orthodontic brackets is high. This study investigated the effects of CO2 laser and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on enamel white spot lesions (WSLs).

In this in vitro study, 60 human premolars were stored in a demineralizing solution for 12 weeks to induce WSLs, and divided into four groups (n=15) of no surface treatment (control), CPP-ACP paste application for 4 minutes/day for one week, and CO2 laser (10 mJ, 200 Hz, 10 s) with/without CPP-ACP paste. The teeth were then immersed in artificial saliva for 90 days while being subjected to daily fluoride mouthwash and weekly brushing. Tooth color was measured at baseline, after demineralization, after the interventions, and after 90 days of storage. The Vickers microhardness of the teeth was measured at the enamel surface and 30-, 60-, and 90-µm depths. Data were analyzed by one-way and repeated measures ANOVA and Friedman test. 

No significant difference was found among the four groups concerning color change, and all groups had clinically detectable discoloration after remineralization. Laser irradiation through CPP-ACP paste caused a significant increase in microhardness compared to CPP-ACP alone and the control group (P<0.05). Microhardness at 30-, 60- and 90-µm depths was also significantly greater in laser/CPP-ACP compared to other groups (P=0.0001).

Application of fractional CO2 laser with/without CPP-ACP paste was not effective in improving the color of WSLs. However, application of CO2 laser through CPP-ACP may be suggested for rehardening of demineralized enamel.

 Applying autologous growth factors and diode laser in periodontal therapy enhances fibroblast-mediated new attachment and osteoblastic differentiation. Hence, this study compared and evaluated the effectiveness of concentrated growth factor (CGF) alone and with diode laser application in managing intrabony periodontal defects.

 Ten patients with stage III periodontitis were included in this study. All the patients underwent an open flap debridement (OFD) procedure followed by CGF membrane placement in the intrabony defect in site A, whereas, in site B, after OFD, all the patients underwent diode laser irradiation before CGF membrane placement. Plaque and gingival bleeding index (PI & GBI), PPD, and clinical attachment level (CAL) were evaluated at baseline and 3 and 6 months later. Bone fill (BF), BF%, bone crest changes (BCC), and BCC% were assessed radiographically at six months postoperatively.

 Significant reductions in PI and GBI scores, probing pocket depth (PPD), and CAL gain were observed at both sites 3 and 6 months from baseline. A significant reduction in PPD and CAL gain was noted between sites, which were higher in site B than in site A with a mean difference of 0.70±0.05 mm and 1.30±0.18 mm, 0.90±1.89 mm at 3 and 6 months, respectively. Radiographic measurement showed better BF, BF%, BCC, and BCC% at both sites at six months, which were higher at site B than at site A but statistically insignificant.

 The combination of CGF and diode laser application has demonstrated successful and promising results in terms of regeneration, improving the clinical and radiographic parameters.

This study assessed the effects of blue and Er:YAG lasers, fluoride varnish, and their combination on microhardness, and calcium and phosphorus content of demineralized enamel.

The primary Vickers microhardness of 28 third molars was measured and their enamel calcium and phosphorous content was quantified by energy-dispersive X-ray spectroscopy. They were then randomly assigned to five groups of 5% sodium fluoride (NaF) varnish, 445nm blue laser, Er:YAG laser, 5% NaF + 445nm blue laser, and 5% NaF + Er:YAG laser. The teeth then underwent pH-cycling to induce caries-like lesions. The surface microhardness of the teeth and the calcium and phosphorous content of demineralized enamel were measured again. Data were analyzed by one-way ANOVA and Tukey’s test (alpha=0.05).

NaF, NaF-diode laser, and NaF-Er:YAG laser groups experienced a significant increase in microhardness of demineralized enamel close to the baseline value (P<0.05). The efficacy of NaF-blue laser and NaF-Er:YAG laser was higher than NaF . In blue and Er:YAG laser groups, the mean final microhardness was significantly lower than the baseline microhardness. The percentage of phosphorus in all groups was similar to that of sound enamel. The percentage of calcium in NaF group was significantly lower than that of sound enamel and all other groups. The calcium content in other groups was similar to that of sound enamel.

Fluoride varnish had a synergistic effect with Er:YAG and blue lasers to increase the demineralized enamel microhardness; blue and Er:YAG lasers alone were less effective.

Porcelain chipping and delamination are among the shortcomings of all-ceramic restorations. This study aimed to assess the effect of laser irradiation and sandblasting on shear bond strength (SBS) of zirconia to veneering porcelain.

In this in vitro, experimental study, 60 zirconia blocks were randomly divided into three groups (n=20) for surface treatment with Er:YAG laser, sandblasting, and no surface treatment (control). Each group was randomly divided into two subgroups (n=10) for porcelain application by the layering or the pressing technique. The surface roughness, SBS, and failure mode were determined and analyzed using two-way ANOVA, Tukey’s HSD test, Chi-square test, and Pearson’s correlation test (alpha=0.05).

The mean SBS was 8.16±3.66 MPa, 9.32±2.7 MPa, and 11.85±3.06 MPa in the control, laser, and sandblasting groups, respectively. The SBS was significantly different among the three groups (P=0.002). The failure mode of the three groups was not significantly different (P>0.05). The sandblasted group showed significantly higher surface roughness than the control and laser groups (P<0.001).

Sandblasting yielded higher SBS particularly when the porcelain was applied by the layering technique. Although laser irradiation increased the SBS, the difference with the control group was not statistically significant.

 This study assessed the effects of two remineralizing agents namely MI Paste Plus containing casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACFP) and Remin Pro containing hydroxyapatite, fluoride and xylitol (HFX) with/without erbium-doped yttrium aluminium garnet (Er:YAG) and CO2 laser irradiation on demineralized enamel microhardness.

In this in vitro study, 70 sound human premolars were mesiodistally sectioned, demineralized at a pH of 4.6 for 8 hours, and randomly divided into 7 remineralization groups (n=10): of (I) MI Paste Plus (CPP-ACFP), (II) Remin Pro (HFX), (III) MI Paste Plus+CO2 laser (0.7 W power, 50 Hz), (IV) Remin Pro+CO2 laser, (V) MI Paste Plus+Er:YAG laser (1 W power, 10 Hz), (VI) Remin Pro+Er:YAG laser, and (VII) negative control. The Vickers hardness number of specimens was then measured. The groups were compared by one-way ANOVA and Tukey’s test (α=0.05).

The mean microhardness was 319.8±49.9, 325.3±44.6, 359.4±35.7, 296.4±33.7, 319.9±58.1, 358.9±28.4, and 240.0±41.6 kg/mm2 in groups 1 to 7, respectively. The difference in microhardness was significant among the groups (P<0.0001). Pairwise comparisons revealed significant differences in microhardness between all groups (P≤0.03) except between groups 1 and 2, 1 and 5, 2 and 5, and 3 and 6 (P>0.05).

Both Remin Pro (containing HFX) and MI Paste Plus (containing CPP-ACFP) can cause enamel remineralization.  MI Paste Plus+CO2 laser irradiation and Remin Pro+Er:YAG laser irradiation were significantly more effective than the application of each remineralizing agent alone.

Diode lasers can be used in the treatment of periodontal diseases as they have an anti‑bactericidal effect, and regulate oral tissue inflammatory responses. This study aimed to evaluate the adjunctive effects of Diode 940 nm laser on mechanical periodontal debridement.

In this split‑mouth single‑blind randomized clinical trial, 12 patients were selected. Forty‑four oral segments were enrolled in the scaling and root planing (SRP) group and SRP + Laser group with a 1:1 allocation ratio following a simple randomization procedure (coin flip). Clinical parameters (pocket depth, clinical attachment loss [CAL], and bleeding on probing [BOP]) were measured at baseline. After the SRP, a 940 nm Diode laser (1 Watt power and continuous wave mode) was used in the SRP + Laser group as an adjunctive treatment. The clinical parameters were remeasured 2 months posttreatment. Statistical analysis was carried out using an unpaired t‑test with a 5% significant level by SPSS.

Although all clinical parameters had more improvements in the SRP + Laser group, the differences were not significant between the two study groups (P > 0.05). Only in individual tooth evaluations, CAL changes in first and second premolars and BOP changes in second premolars show statistically significant improvement in the SRP + L group compared to the SRP group (P < 0.05).

Using diode 940 nm laser as an adjunctive treatment for SRP may be helpful and be suggested for periodontal treatment.

 Clinical long-term success of bonded restorations is depended to reduce marginal microleakage and the laser application with combination of new bonding systems may play positive role. The aim of this study was comparative evaluation of Er,Cr:YSGG and Nd:YAG lasers effect on microleakage of class V composite resin restorations using several universal adhesives.

 In this in vitro study, standard class V cavities were prepared on both lingual and buccal surfaces of 72 intact premolar teeth. For evaluation of microleakage, the cavities were divided into 9 groups according to conditioning method (n=15): G1: G-Premio Bond [GP]; G2: Scotchbond Universal Adhesive [SU]; G3: All-Bond Universal [AB]; G4: GP+Nd:YAG Laser; G5: SU+Nd:YAG Laser; G6: AB+Nd:YAG Laser; G7: GP+Er,Cr:YSGG Laser; G8: SU+Er,Cr:YSGG Laser; and G9: AB+Er,Cr:YSGG Laser. The cavities were filled with composite resin and then subjected to thermocycling, placed in methylene blue solutions, embedded in resin blocks and vertically cut in the bucco lingual direction. The microleakage in occlusal and gingival margins was defined as linear penetration of methylene blue and determined with a stereomicroscope to assign microleakage scores using a four point scale. Data were analyzed by using SPSS software and Kruskal-wallis and Mann-Whitney U tests.

 Microleakage scores had statistically significant different before and after laser irradiation in dependent to the adhesive used (P<0.05) but there were no significant different between Nd:YAG and ER,Cr:YSGG laser, also between different universal adhesives (GP, SU, AB). The results showed that total microleakage scores of occlusal margins had significant statistical different in comparison with gingival margins (P<0.001).

 The results indicate that Nd:YAG and Er,Cr:YSGG lasers irradiation, after using the investigated universal adhesives, had a positive effect on reducing the microleakage of composite Class V restorations. The microleakage rate was shown to be independent of adhesives and lasers type used in this study.

 Today, the solutions for skin aging and rejuvenation methods are of special importance.

 This study aims to investigate the desire to perform various methods related to facial rejuvenation in Iran and the world.

 It is an ecological study conducted using the Google Trends (GT) database. We initially searched for users' specified search terms related to "Botox," "Gel injection," "Laser," "Facelift," "Fillers," and "COVID-19" among all searches performed using GTs in the world and Iran from January 2017 to July 2023.

 The trend of GT shows that the search volume for laser and filler services is higher than for other services worldwide. In Iran, laser and gel injections had the highest search volume until 2022. However, from 2022 onwards, fillers have become one of the top searched services. In 2020, with the onset of the COVID-19 pandemic, the significant impact of the pandemic on facial rejuvenation procedures worldwide, including in Iran, became evident. There is a significant negative correlation between the volume of searches for COVID-19 and facial rejuvenation procedures worldwide (R2 = -0.52, P = 0.0001) and in Iran (R2 = -0.84, P = 0.0001).

 Many people worldwide and in Iran are looking for facial rejuvenation. Clinicians can enter this business with a positive outlook. GT data is a powerful tool for predicting the demand for facial rejuvenation procedures.

This study compared two groups of twin pregnancies complicated by twin-to-twin transfusion syndrome (TTTS), with and without selective fetal growth restriction (sFGR), and evaluated the survival rate at 30 days after birth treated with fetoscopic laser photocoagulation (FLP).
Materials &

The present study was a retrospective study of 164 diamniotic monochorionic twin pregnancies complicated with TTTS and treated with FLP. The sFGR was defined as an estimated fetal weight below the 10th percentile. The independent t-test, Chi-square test, or Fisher's exact test were used for statistical analysis. Multiple logistic regression analysis was performed to identify 30-day donor twin survival risk factors for the entire study population. The significance level was determined at p<0.05.

Of the studied cases, 45.1% had only TTTS, while 54.9% had both TTTS and sFGR. .There was a significant difference (p<0.001) in the distribution of Quintero stages and maternal age during the intervention (p=0.01) between the two groups. The sFGR before laser surgery in TTTS patients was associated with reduced donor survival. The multivariate analysis revealed that gestational age at delivery (OR=0.81, 95%CI:0.7-0.8) and sFGR (OR=0.43, 95%CI:0.2-0.8) were significantly associated with donor survival.

The sFGR before FLP is present in approximately 55% of TTTS cases, which is caused by normal placental abnormalities. TTTS with sFGR is associated with reduced donor embryo survival. Gestational age at delivery and sFGR are important factors affecting donor survival 30 days after birth. Performing successive ultrasounds after diagnosing monochorionic twin pregnancies is essential for timely identification, correct management, and treatment.

Shock wave‑enhanced emission photoacoustic streaming (SWEEPS) is a novel irrigation activation method based on photoacoustic streaming. The aim of this study was to look into the impact of SWEEPS on the attachment and survival of dental pulp stem cells (DPSCs).

In this in vitro study, 34 standardized root segments were randomly allocated into two groups: SWEEPS and the conventional conditioning group. After the irrigation, human DPSCs were seeded on the internal walls of these samples, and the attachment and survival of 30 of them were assessed on different days. The remaining two samples were observed using a scanning electron microscope (SEM). Independent sample t‑test, Mann–Whitney U‑test, one‑way ANOVA, Kruskal–Wallis, and two‑way ANOVA were used for data analysis with the level of significance = 0.05.

The viability of DPSCs was significantly greater in the SWEEPS group in comparison with the conventional conditioning group (P = 0.029). Both groups have shown a significant increase in the viability of DPSCs over time (P = 0.0001, P = 0.003). SEM results have shown a smear layer‑free surface with firmly attached DPSCs in the SWEEPS group.

The results of this study indicated that active irrigation using SWEEPS could provide a superior surface in terms of viability and attachment of DPSCs compared to the conventional conditioning method.

This study aimed to assess the effect of photodynamic therapy (PDT) on the pushout bond strength (PBS) of resin-based and calcium silicate-based endodontic sealers.

Forty single-canal teeth were assigned to four groups. After root canal preparation by the crown-down technique and smear layer removal, groups 1 and 2 served as the control group, and groups 3 and 4 underwent PDT by using a low-level diode laser as the light source and methylene blue as the photosensitizer (MB). The root canals in groups 1 and 3 were filled with AH26 sealer while the root canals in groups 2 and 4 were filled with Endoseal TCS. The samples were sectioned at 4, 8, and 12 mm from the apex tip (1mm thick slices). The PBS test was performed, and the mode of failure was determined in the coronal, middle, and apical thirds. The data were analyzed by the Kruskal-Wallis, Friedman, and Dunn tests.

No significant difference was noted in the PBS of resin-based and calcium silicate-based sealers in the apical, middle, or coronal thirds in the application of PDT (P > 0.05). The PBS of AH26 was significantly higher than that of Endoseal TCS (P < 0.05). Cohesive failure was the dominant mode of failure in the AH26 groups, while mixed failure was the dominant failure mode in the Endoseal TCS groups.

PDT had no significant effect on the PBS of resin-based and calcium silicate-based sealers.

Nowadays, facial esthetics has become the main concern for many people. Gummy smile (GS) is a common complaint that affects the esthetics and psychological status of patients. The aim of this study was to review GS treatment options.  

An electronic search was conducted in three databases of PubMed, Wiley and Cochrane Library from January 2015 up to August 2021. According to the eligibility criteria, a total of 41 relevant papers were retrieved and reviewed.

Based on the available data, several techniques have been reported for GS treatment, such as lip repositioning, crown lengthening, orthognathic surgery, laser application, botulinum toxin (BT) injection, hyaluronic acid injection, and micro autologous fat transplantation (MAFT). Combination of two or three of these techniques may yield a better result.

A wide variety of procedures are available based on the cause of GS. The new, less invasive, faster and safer alternative techniques were shown to be feasible with a long-lasting result and minimal postoperative sequelae. Such treatment options for various types of GS can lead to significant improvement in smile esthetics with high patient satisfaction.