Evaluation of the botulinum toxin effects in the correction of gummy smile 32 weeks after application

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Carlos Eduardo Alonso Vieira
Wilson Rodrigues de Almeida
Paula Cotrin
Renata Cristina Gobbi de Oliveira
Ricardo Cesar Gobbi de Oliveira
Fabrício Pinelli Valarelli
Julie Watanabe Zamuner
Karina Maria Salvatore de Freitas


Introduction: The use of botulinum toxin type A (BTX-A) to correct gummy smile has become popular in recent years. Objective: To evaluate the effects of BTX-A application in the correction of gummy smile 2 and 32 weeks after application. Methods: The sample comprised 35 patients (30 female, 5 male) at a mean age of 25.51 years (±5.59) with gummy smile due to muscular hyperfunction. In each patient, 2U of botulinum toxin was applied in the levator labii superioris alaeque nasi, 2 mm from the nasolabial fold. Photographs of spontaneous smiles were taken at 3 stages: before, 2 and 32 weeks after BTX application. Measurements of the gingival display were performed with the Radioface Studio 2 Software, and the calibration used the actual size of the right maxillary central incisor. Comparison of the three stages evaluated was performed with repeated measures ANOVA and Tukey tests. Results: Gingival display decreased significantly 2 weeks after BTX-A application and increased after 32 weeks but did not return to the initial value. Conclusion: There was a significant improvement in gummy smile 2 weeks after botulinum toxin application, and a significant relapse in the gingival display after 32 weeks, however not returning to baseline values.


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Vieira, C. E. A., Almeida, W. R. de, Cotrin, P., Oliveira, R. C. G. de, Oliveira, R. C. G. de, Valarelli, F. P., Zamuner, J. W., & Freitas, K. M. S. de. (2022). Evaluation of the botulinum toxin effects in the correction of gummy smile 32 weeks after application. ABCS Health Sciences, 47, e022201. https://doi.org/10.7322/abcshs.2020052.1501
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