Botulinum Toxin-A in the Treatment of Excessive Gingival Display: A Clinical Study

The aim of this study was to elucidate the efficiency of BTX-A injections as an alternative approach in patients with excessive gingival display and to observe the patient's satisfaction in order to obtain cosmetically promising results.

Fifteen patients of whom ten female and five male with different types of gummy smiles such as anterior (53%), posterior (7%) and mixed (40%) reported to the Department of Oral and Maxillofacial Surgery at Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu from December 2018 to October 2019 those who were willing to undergo corrections using Botulinum Toxin Type A (BTX-A) were selected for the present study using various inclusion and exclusion criteria. The patients were injected with BTX-A on Yonsei triangle accordingly. The clinical evaluation and patient satisfaction evaluation were carried out.

A significant decrease in the gingival exposure of about 3.5 ± 1 mm at 2 weeks after injection was observed and it lasted for 4 months. It was also noted that there was no difference in the measurement of gingival display on maximum smile for postinjection during 5th and 6th month when compared with preinjection measurements. This study confirms that the efficacy of BTX A injection lasted for 4 months and then gradually reduced resulting in reversal of gingival display during maximum smile.

The authors conclude that in the cosmetic correction of gummy smile by BTX-A, it is important to identify the type of smile and the main muscles involved, so that the correct injection technique can be used. It also confirms that BTX-A is a novel, competent, risk-free and minimally invasive nonsurgical therapy that can extensively improve smile aesthetics.