Evaluation of the effectiveness of anterior segmental maxillary osteotomy in management of anterior vertical maxillary excess associated with gummy smile: A clinical study

To evaluate the effectiveness of anterior segmental maxillary osteotomy in improving The amount of gingival exposure (above incisors and above canines) and the measurement of the nasolabial angle and increasing patient satisfaction in cases of excessive vertical growth of the upper jaw associated with a gummy smile. 10 female patients, aged 20–34 years, were diagnosed with anterior vertical maxillary excess combined with a gummy smile. They underwent anterior segmental maxillary osteotomy using digital three-dimensional planning. Gingival exposure above the incisors and canines and the nasolabial angle were measured. Patient satisfaction was assessed using a numerical scale from 1 to 5 six months post-surgery. The findings demonstrated a statistically significant reduction in gingival exposure (from 7.00 mm to 1.20 mm above incisors, with an 97.14 % improvement) and (from 6.30 mm to 1.40 mm, with a 93.65 % improvement).And nasolabial angle(from 84.24° to 98.77° with 92.20 %).The average patient satisfaction score was 4.70 out of 5, with a low standard deviation (0.48), indicating a high level of satisfaction consistency among the patients. Anterior segmental maxillary osteotomy is an effective and safe technique for improving gingival exposure over the maxillary incisors and canines, optimizing the nasolabial angle, and enhancing patient satisfaction in cases of excessive vertical maxillary growth associated with a gummy smile, particularly when performed with digital planning. • 3D digital planning enhanced surgical precision, allowing customized osteotomy lines and improved symmetry of dental and facial outcomes. • Using a minimally invasive segmental approach (vs. full Le Fort I), the technique preserved midface structure while effectively managing excessive gingival display. • Results demonstrated that Cupar technique is not only effective esthetically, but also functionally—reflected in occlusal correction and high patient satisfaction.