The effect of botulinum toxin A in patients with excessive gingival display with and without zinc supplementation: randomized clinical trial

Shemais, Nesma; El-Arab, Azza Ezz; Nahass, Hani El

doi:10.1007/s00784-021-03944-2

Cited by 7 publications

(24 citation statements)

References 34 publications

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“…A classification by Mazzuco and Hexsel categorizes excessive gingival display based on their area [ 9 ]. Four types of gummy smiles were presented: posterior, anterior, asymmetric, and mixed gummy smiles [ 4 , 8 , 15 ]. A posterior gummy smile is associated with normal exposure in the anterior region (<3 mm) and more than 3 mm of exposed gingiva posterior to the canines.…”

Section: Reviewmentioning

confidence: 99%

“…Botulinum toxin was first used in the 1970s for the treatment of excessive muscle contraction and pain. This toxin is typically produced by the bacteria Clostridium botulinum [ 6 , 15 ]. Clostridium botulinum is an anaerobic and gram-positive rod bacterium with eight serotypes and provides seven botulinum neurotoxins (A-G) [ 3 , 4 ].…”

Section: Reviewmentioning

confidence: 99%

“…Botulinum toxin is a minimally invasive approach for the treatment of gummy smiles especially due to hyperactive lip muscles [ 5 , 16 , 17 ]. The effectiveness of botulinum toxin depends on zinc as each Botox molecule must be associated with a molecule of zinc in order to be effective [ 15 ]. Botulinum toxin causes chemical denervation of muscles in the skeletal region, thus resulting in a transitory reduction of muscle activity without systemic manifestations.…”

Section: Reviewmentioning

confidence: 99%

“…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 ].…”

Section: Reviewmentioning

confidence: 99%

“…Myotomy with lip repositioning was reported to provide more stability in the long term compared to repositioning without myotomy. Yet, few patients considered the result to be satisfying [ 15 ]. Relevant clinical studies discussing the use of Botox for gummy smile treatment are presented in Table 1 .…”

Section: Reviewmentioning

confidence: 99%

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

Fatani¹

2023

Cureus

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Excessive gingival exposure (gummy smile) is a non-aesthetic condition characterized by excessive exposure of the gingiva during smiling. The most common cause of gummy smiles was reported to be the hyperfunction of the muscles of the upper lip. Previous reports showed that botulinum toxin (Botox) is effective in the treatment of gummy smiles with a reversible effect, rapid initial action, safe application, low risk, and satisfactory outcome. The effect of Botox is usually observed between one and two weeks. This study aims to review the recent updates and guidelines for gummy smile treatment using botulinum toxin. A literature review was conducted involving relevant studies discussing gummy smile treatment using botulinum toxin with no time restriction. The PubMed and Google Scholar databases were used to gather the most relevant studies. The initial screening revealed 62 studies, and after removing the out-of-scope studies, the final review included 28 studies. Botulinum toxin can be used effectively for the treatment of gummy smile caused by lip dynamics with rarely reported complications. However, the most observed limitation was the temporary duration, which was reported to range from four to six months, and the reinjection of botulinum toxin is usually needed.

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