Combined Effects of Botulinum Toxin Injection and Oral Appliance Therapy on Lower Facial Contouring: A Randomized Controlled Trial

Abstract

(1) Background: Botulinum toxin (BoNT) injection is an esthetically effective and safe treatment for contouring the lower face. This study aimed to evaluate the combined effects of BoNT and supplementary oral appliance (OA) therapy on lower facial contouring. (2) Methods: We conducted a prospective randomized controlled trial from January 2015 to June 2016 at the Yonsei University Dental Hospital. Volunteers aged 20–45 years with masseter hypertrophy were randomly assigned to one of two groups: the non-OA group and the OA group. The non-OA group received BoNT injections alone, whereas the OA group received an OA in addition to BoNT injections. Changes in the bulkiest height of the lower face were evaluated by three-dimensional laser scanning before and 4, 8, 12, and 24 weeks after injections in both groups. (3) Results: In both groups, the bulkiest height reductions decreased, with a significant interaction between group (p = 0.046) and time (p < 0.001), although the overall reduction was at a similar level at 24 weeks. (4) Conclusions: The pattern of the bulkiest height reduction of the lower face after BoNT injection differed between standalone treatment and OA therapy, implying a normalizing effect of OA on masseter muscle activity.

Botulinum Toxin Type A and Hyaluronic Acid Dermal Fillers in Dentistry: A Systematic Review of Clinical Application and Indications

“…The review also examined the efficacy of BoNT-A in dental applications across six studies [ 16 - 19 , 22 , 23 ] ( Supplementary Material 1 , www.jocmr.org ). One study demonstrated reduced exposed gingiva and muscle activity with BoNT-A injections for gummy smile treatment [ 16 ].…”

“…Combined BoNT-A and oral appliance were suggested for effective lower face contouring. Additionally, reduced gingival display with zinc supplementation + BoNT-A was demonstrated, indicating its prolonged efficacy in maintaining decreased gingival display [ 22 , 23 ]. These findings underscore BoNT-A’s diverse therapeutic potential in enhancing oral health and esthetics, ranging from gummy smile treatment and MFP management to lower face contouring in dental practice.…”

“…The review examined six RCTs on BoNT-A’s applications in dentistry [ 16 - 19 , 22 , 23 ]. BoNT-A injections addressed gummy smiles, MFP, and mandibular motion issues [ 16 - 19 ].…”

“…BoNT-A injections addressed gummy smiles, MFP, and mandibular motion issues [ 16 - 19 ]. They also reduced gingival display and enhanced lower facial contours [ 22 , 23 ] ( Table 2 , Supplementary Material 1 , www.jocmr.org ).…”