Commentary on: Botulinum Toxin for the Treatment of Excessive Gingival Display: A Systematic Review

An interview with Mario Polo

“…After publication of the results attained, I went through a dose modification process, which, after being reviewed twice, the current injection protocol was established and published. 3 , 4 Based on the amount of exposed gingival tissue when smiling, four doses are currently used with much esthetic success being accomplished ( Table 1 ). Please refer to before and after photos ( Fig 4 ) of four individuals with GE levels corresponding to, and treated with these four doses.…”

“…The number of individuals has now increased from the amount you refer to and reported in 2016. 4 Several cohorts have resulted along the 15 years that I have been injecting BTX-A for the temporary correction of gummy smiles. The one with the longest number of injection sessions contains 1 individual who has had 22 injection sessions within 11 years she has been under my care.…”

A successful management of sever gummy smile using gingivectomy and botulinum toxin injection: A case report

“…4 a. This approach was in disagreement with polo’s opinion [ 35 ] as he stated that the total dose of BT injection should be 10 U if the gingival exposure was more than 8.5 mm and the orbicularis oris muscle should not be injected. But in our case, results start to be more observed and effective after increasing the dose of Botox to reach 20 U and also after injection of orbicularis oris.…”

Botulinum toxin injection to treat a gummy smile: A few observations

“…In the discussion, the authors justified the selection of orbicularis oris site for the study by citing Polo. 4 However, in a recent commentary, Dr Polo 5 has strongly objected to this technique saying, "With extensive experience in injecting botulinum toxin for gummy smiles, I am of the opinion that the OO muscle should never be injected for this particular purpose. "…”