Management of excessive gingival display using botulinum toxin type A: a descriptive study

Non-Surgical Management of the Gingival Smile with Botulinum Toxin A. A Systematic Review and Meta-Analysis.

“…There is a signi cant discrepancy in the follow-up time periods after the intervention. However, the studies with a review at six months 5,9,14,15,28,31 after in ltration with BTX-A showed a tendency to recurrence in the gummy smile. Research studies with a longer follow-up time, at eight 27 and nine months 5 , found gingival exposure values similar to those studied before in ltration.…”

“…The method used frequently to evaluate the reduction of gummy smile after treatment was the one used by Polo in 2005 11 , using the upper right central incisor to calibrate the images of each patient from the highest point of the gingival zenith to the incisal edge. 5,8,12,14-15,26-28 However, other authors 9 took the upper lateral incisor as a reference, measuring the distance between its central cervical area to the lower part of the upper lip. Mazzuco and Hexsel., 2010 1 in two of their four study groups used the upper central incisors and in another two upper premolar groups when evaluating a more posterior gummy smile, however Sucupira and Abramovitz., 2012 16 used only the upper central incisors, Suber et al, 13 and Dutra etal., 25 also used the upper central incisor although its gingival measurement was the distance between the stomion point of the upper lip and the incisal edge of the upper central incisor subtracting the length from it.…”

“…2,13 The moderate gingival smile or the patients who refuse the surgery could be treated with a more conservative treatment by the BTX-A in ltration, as long as the patient agrees with the temporality and understands that it is not the gold standard treatment. 1,9,13,15 As the surgical infra-correction, to handle mild gingival smile by BTX-A in ltration is also one option to temporary control the over exposure without aging consequences; as the aging tissue laxity progresses, the most of the mild cases will show a proper quantity of gingival exposure.…”

“…6,7 The multi-factorial nature of the smile requires an individualized diagnosis in each patient, since there are multiple ways to treat the gummy smile (orthognathic surgery, gingivoplasty, orthodontic intrusion, myotomy...). 1,[8][9] In recent years, interest has grown in the simplest techniques that allow the patient to quickly return to their usual routine, such as lip replacement. However, this procedure shows recurrences in the rst 6-8 post-operative weeks.…”

An Approach for Gummy Smile Treatment Using Botulinum Toxin A: A Narrative Review of the Literature

“…This in turn yields partial chemical denervation. The outcome is a relaxation of the elevating action of the lip and a localized decrease in the activity of the elevator muscle [ 5 , 7 , 8 , 14 , 15 , 18 ]. Botox was confirmed by previous studies to be a suitable diagnostic method, as well as palliative treatment, for the treatment of gummy smiles [ 13 ].…”