A noninvasive myorelaxant approach resulting in gummy smile improvement-A pilot study

The opportunity to shape facial appearance through noninvasive muscle relaxation procedures remains largely unfulfilled. Here, a hypothesis was tested whether an intraoral application of a mucoadhesive, biodegradable slow release formulation may trigger beneficial cosmetic outcomes in and around the mouth.

A clinical case study was designed to determine the effect of a transbuccal delivery of a formulation containing a botanical muscle relaxant on the appearance of the smile line. The ingredients of this formulation were then tested for metalloproteinase inhibition, in fibroblast culture model, to further determine their value for intraoral application.

A bioadhesive patch device was engineered and applied under the upper lip of three volunteers. Changes in gingival coverage were interrogated by morphometry. Levels of MMP1 and MMP3 in fibroblast culture-conditioned medium were measured by sandwitch ELISA and cell proliferation by sulforhodamine B method.

The cosmetic benefit of the transoral delivery of skeletal muscle relaxing formulation was demonstrated by loosening upper lip skin and improving the gummy smile condition. The ingredients of that formulation also had an inhibitory effect on MMP1 and MMP3 protein level in vitro, and enhanced cell proliferation in the adult fibroblast model.

Taken together, these results indicate that the transbuccal delivery platform is an effective approach to improve gingival coverage, while potentially providing beneficial functionality for both skin and the oral cavity.