Botulinum Toxin Type-A for the Treatment of Excessive Gingival Display on Smiling

To determine the effect of botulinum toxin type-A (BTX-A) in reducing gummy smile.

This was an interventional case series conducted at a tertiary care setting in Mangaluru, Karnataka, India. Twenty patients with the gingival display of >3 mm were selected through convenience sampling technique. 2.5 units of BTX-A were injected under sterile conditions on either side of the face. The effect of the injection on gingival display was measured at the interval of 2, 4, 12, and 24 weeks. At the end of the treatment, the patient was asked to smile and was photographed and was compared to pretreatment photo. Repeated measures analysis of variance (ANOVA) was used to detect the change at each interval and intergroup comparisons were performed using post hoc Bonferroni test.

The mean gingival exposure reduction from 4.93 to 3.705 mm at week 2. At the end of 24 weeks, the evaluation showed the mean gingival display of 4.755 mm on administration of 2.5 units on either side. The photographs also showed the change in smile at the end of the treatment.

From the study, it was inferred that botulinum toxin was effective in eliminating gummy smile along with noticeable decrease in the nasolabial fold despite for the effect lasting only about 24 weeks.

A nonsurgical method of correction of gummy smiles when compared to surgical intervention is readily accepted by patients. Botulinum toxin type-A for gummy smiles is an effective, conservative, and satisfactory technique.