Treatment of Various Types of Gummy Smile With Botulinum Toxin-A (original) (raw)
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Improvement of Severe Gummy Smile by Botulinum Toxin Application and Gingivoplasty
Journal of Nepalese Society of Periodontology and Oral Implantology, 2018
Currently, the search for aesthetic excellence has become the main objective in the dental treatment. The gummy smile is one of the complaints from the patients, since this situation may influence their self-esteem and social relationship. The development of new techniques, such as the application of botulinum toxin, may be a therapeutic option more conservative, in the treatment of gummy smile. The purpose of this article is to present a case of a patient with dentogingival discrepancy and severe gummy smile, who was treated with gingivoplasty and application of botulinum toxin in order to optimise the harmony of the smile.
Gingivoplasty and botulinum toxin application result in improvement of severe gummy smile
2020
Background Currently, the search for esthetic excellence has become the main objective in dental treatment. Gummy smile is among patients’ complaints, since this condition may influence their self-esteem and social relationships. The development of new techniques such as the application of botulinum toxin may offer more conservative therapeutic options for the treatment of gummy smile. Case presentation A patient with dentogingival discrepancy and severe gummy smile was treated with gingivoplasty and application of botulinum toxin in order to optimize the harmony of the smile. The result was satisfactory regarding the harmony of the smile by combination of the treatments. The use of each of these treatments alone could not have achieved the excellence of the result. Initially, the creation of the new gingival zenith after gingivoplasty promoted the new dental architecture, favoring gingival, dental and facial harmony for the patient. Subsequently, the application of botulinum toxin ...
Adjunctive Treatment of Gummy Smile Using Botulinum Toxin Type-A (Case Report)
IOSR Journal of Dental and Medical Sciences, 2012
A 13 Year old female came for a consultation with chief complaints of protrusive lips and a gummy smile. The clinical examination showed a convex profile, a retrognathic mandible, excessively proclined and extruded maxillary incisors, and skeletal class II malocclusion with bimaxillary dento alveolar protrusion. Treatment was started using conventional mechanics for intrusion and retraction of upper anterior teeth, thereby improving soft tissue profile and correction of gummy smile. But only orthodontic treatment was not enough for correction of excessive gingival display during smile secondary to hyperactive upper labial muscle activity. Thus injection of Botulinum toxin type-A was given to correct gummy smile as an adjunctive treatment. Excellent correction of gummy smile following 2 weeks of Botox injection was achieved without any side effects. The patient received a satisfactory occlusion and an attractive smile.
Gummy smile and botulinum toxin: A new approach based on the gingival exposure area
Journal of the American Academy of Dermatology, 2010
Background: Gummy smile (GS) is an aesthetic disorder for some patients, which can be corrected by injection of botulinum toxin. Objective: We sought to classify GS according to the area of gingival exposure and the respective muscles involved in order to perfect the botulinum toxin injection technique for each patient. Methods: Sixteen patients with GS were evaluated before receiving botulinum toxin injections. Based on the area of excessive gum displayed and identification of the muscles involved, 4 different types of GS were identified: anterior, posterior, mixed, and asymmetric. AbobotulinumtoxinA (Dysport, Ipsen Biopharm Limited, Wrexham, UK) was injected using a different injection technique for each type of GS, based on the main muscles involved. With the aid of two computer programs, the area of gum exposed was measured before and after the application of abobotulinumtoxinA, to evaluate the level of improvement. Results: There was a decrease in the degree of gum display in all patients. The general average improvement achieved was 75.09%. Two patients showed slight adverse effects that were easily corrected with additional doses of abobotulinumtoxinA. Limitations: For this study, there was no sample size calculation and no statistical analysis of the cases. Conclusion: The authors conclude that it is important to identify the type of GS and therefore the main muscles involved, so that the correct injection technique can be used. AbobotulinumtoxinA was shown to be effective and safe for use in all types of GS in the present sample.
Treatment of Gummy Smile Using Botulinum Toxin Type-A (Case Report)
2014
Extensive exposure of the gingiva during a smile, called excessive gingival display, may be a cause of concern for both patients and clinicians.When an excess of gingiva superior to the maxillary anterior teeth is displayed upon full smile, it is termed a gingival smile or Gummy smile. Treatment modalities for gummy smile change according to its etiology.This article examines a non-surgical treatment option for reducing the excessive gingival display ('gummy smiles'), which can be found in many patients. Botulinum toxin type A (BTX-A) (Botox; Allergan) has been studied since the late 1970s for the treatment of several conditions associated with excessive muscle contraction. If carefully administered, this procedure is a very quick, reliable and predictable treatment option for most appropriate cases and should be considered as a viable modality before embarking on any anterior cosmetic dentistry or indeed facial aesthetic treatment for the lips themselves.
Treatment of gummy smile using botulinum toxin: a review
Journal of Dental Rehabilitation and Applied Science, 2021
A beautiful smile is made when it is symmetrical and gums are displayed less than 2-3 mm. Excessive gingival display also known as "gummy smile" is often recognized to be unaesthetic. Causes of gummy smile can be caused by delayed eruption, vertical maxillary excess, hypermobile upper lip, or a short upper lip. Meanwhile botulinum toxin which is an exotoxin produced from Clostridium botulinum, works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles. The application site and weakens the muscle tone is drawing attention as a gummy smile treatment caused by hypermobile upper lip. There have been many studies about the method of injecting botulinum toxin into muscles around the lips, but there is still no standardized research method and treatment method, so there is controversy over the therapeutic effect. The aim of this study is to review the previous studies about the predictors of indication and effects of gummy smile treatment using botulinum toxin injection. Especially we tried to propose a protocol for optimal dose and efficient injection point through the anatomical considerations for gummy smile treatment using botulinum toxin.
Comparison of Botulinum Toxin and Orthognathic Surgery for Gummy Smile Correction
The Open Dentistry Journal, 2020
Objective: This study aimed to compare the changes in the gummy smile in cases treated with botulinum toxin (BTX) application or orthognathic surgery. Methods: The retrospective sample comprised 61 subjects with gummy smile divided into 2 groups according to treatment received for gummy smile correction: 1-38 patients (6 male; 32 female), at a mean age of 28.60 years (s.d.=6.09), treated with BTX application; 2- 23 patients (7 males and 16 females) at a mean age of 29.59 years (s.d.=5.72) treated with orthognathic surgery. Patients from the BTX group refused to undergo orthognathic surgery. The measurement of the gingival exposure was performed in extraoral photographs of the posed smile, before and after treatment, and it was defined as the difference between the stomion of the upper lip and the incisal edge of the maxillary central incisor minus the height of maxillary central incisor obtained in the patient's dental casts. The data were obtained before (T1) and after treatmen...
Clinical case series: Botulinum toxin and the reversible correction of gingival smile
International Journal of Case Reports and Images, 2022
The aim of this study was to evaluate the effect of applying botulinum toxin type A (BTX-A) as a therapeutic alternative for the treatment of gingival smile. Four selected categories of female gender, aged 28-38 years, with gingival smile exposure between 4 and 9 mm, were selected. The evaluation was carried out 15 and 30 days after the initial application. All participants responded to a structured scored interview of initial and final satisfaction. All patients related satisfaction with the final gingival exposure, providing an improvement of their self-esteem. The gingival smile can be treated with botulinum toxin type A as an adjunct to treatments that
INTRODUCTION: A gummy smile (GS) affects the esthetic and the psychological status as it usually decreases the self-confidence leading to hidden or controlling the smile. A smile with more than 2 mm exposed gingiva is called gummy smile. It may be due to one or more of the following etiologies; altered passive eruption of teeth, dentoalveolar extrusion, vertical maxillary excess, and short or hyperactive lip muscles. The treatment of gummy smile should be planned according to its cause/causes. The purpose of this case report was to highlight the ability of combined treatment of gingivectomy and Botox injection technique in managing a severe gummy smile. Also, techniques, advantages, disadvantages, indication and contraindications of Botulinum toxin (BT) are discussed at the literacy. PRESENTATION OF THE CASE: A 24 year old female patient with a severe gummy smile was refereed to the periodontal clinics of our institution. Clinical examination revealed that she has a GS of an 11–12 mm gingival exposed area that was indicated for orthognathic surgery. The GS was treated by a gingivec-tomy surgery to increase the clinical crowns of upper anterior teeth and the use of Botox injections. The treatment showed remarkable and satisfactory results instead of doing extensive surgery. DISCUSSION AND CONCLUSION: It is important to assess the patients' esthetic expectations and show the possible therapeutic solutions that fit him. We revealed that BT is considered as one of the minimally invasive, quick and affordable modalities that can replace extensive surgical procedures for corrections of sever GS.