Botulinum Toxin A in the Management of a Gummy Smile: A Clinical Controlled Preliminary Study

2021 ◽  
Author(s):  
Aline Bitencourt Costa ◽  
Dinete Romansina ◽  
Juliana Ramalho ◽  
Priscilla Pereira ◽  
Tamara Kerber Tedesco ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Botulinum Toxin ◽  
Muscle Activity ◽  
Botulinum Toxin A ◽  
Toxin A ◽  
Significant Difference ◽  
Satisfaction With Treatment ◽  
Group 2 ◽  
Gummy Smile

Abstract Background Botulinum toxin-A (BTX-A) is recent technique to treat gummy smile. Objectives This randomized controlled preliminary clinical trial evaluated BTX-A on excessive gingiva display (EGD) reduction, muscle activity, and patient satisfaction at 2, 8, 12, 16, 21, and 25 weeks. Methods Group 1(G1): 4 points of BTX-A application (2U/point) for relaxation of the levatorlabii superioris alaeque nasi (LLSAN) and levatorlabiisuperioris (LLS) muscles; Group 2(G2): Two points of BTX-A (2U/point) for relaxation of the LLSAN muscle. Results A high dropout of patients during some follow-up sessions occurred. So, considering this data limitation, the results found were considered a preliminary outcome. In 2 weeks, there was a significant difference between baseline regarding the reduction of EGD in G1 and G2, reduction in muscle activity in G1, and increased satisfaction in G1 and G2. In 2 weeks, there was no difference between both groups. Statistical EGD reduction was maintained until 16 weeks for G2 and 25 weeks in G1. After 14 days there was a gradual recovery of muscle activity in both groups until baseline values recovery within 25 weeks. Patients' satisfaction with treatment lasted 21 weeks in G1 and 16 weeks in G2. Conclusions Increasing BTX-A injection points resulted in a prolonged effect regarding EGD reduction and patient satisfaction but did not increase the intensity of the outcome. However, due to the high dropout of patients, this is a suggested preliminary conclusion based on available data and more additional studies are necessary to testify the results described.

scholarly journals Botulinum Toxin Injection with Conjunctival Microincision for the Treatment of Acute Acquired Comitant Esotropia and Its Effectiveness

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hongjia Xu ◽  
Weifeng Sun ◽  
Shuying Dai ◽  
Yanyan Cheng ◽  
Jing Zhao ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Binocular Vision ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Injection ◽  
Age At Onset ◽  
Brain Magnetic Resonance Imaging ◽  
Significant Difference ◽  
Angle Of Deviation ◽  
The Mean

Purpose. To report on an improved botulinum toxin injection with conjunctival microincision for beginners, and to determine the effectiveness of botulinum toxin A (BTXA) in the treatment of patients with acute acquired comitant esotropia (AACE). Methods. Medical records of 29 AACE patients were retrospectively analyzed. BTXA was injected into the unilateral or bilateral medial rectus muscle with conjunctival microincision without electromyographic guidance. Success was defined as total horizontal deviation ≤10 prism diopters (PD) and evidence of binocular vision. Results. Twenty-nine patients were included, of whom 22 were male and 7 were female. The mean age at onset was 14.2 ± 7.4 (range, 4–34) years. The mean time from onset of AACE to injection was 18.4 ± 20.3 (range, 1–96) weeks. All patients completed at least 6 months of follow-up, and the mean follow-up after BTXA injection was 12.3 ± 4.8 months (range, 7–24 months). Neurological evaluation and brain magnetic resonance imaging (MRI) were unremarkable in all patients. The mean spherical equivalent refraction was −1.22 ± 2.85D and −0.97 ± 2.80D in the right and left eyes, respectively. Mean preinjective esotropia was 38.4 ± 18.9 PD (range, +10–+80 PD) at near and 40.2 ± 17.7 PD (range, +20–+80 PD) at far distance. The mean angle of deviation at 6 months after injection was 0.6 ± 4.1 PD (range, −3–+15 PD) at near and 3.0 ± 5.9 PD (range, 0–+20 PD) at far distance. There was significant difference in the angle of deviation at near and far fixation between pre-BTXA and post-BTXA 6 months ( p < 0.001 , p < 0.001 , resp.). There was no significant difference in the angle of deviation at near and far fixation between post-BTXA 6 months and post-BTXA at final follow-up ( p  = 0.259 and 0.326, resp.). Mean stereoacuity improved from 338 to 88 arc seconds. During the follow-up period, 5 of 29 patients had recurrent esotropia. Two patients refused all further treatment, and the other 3 patients required incisional strabismus surgery. The success rates were 86.2% (25/29) at 6 months and 82.8% (24/29) at final follow-up. Conclusion. Conjunctival microincision injection of botulinum toxin is a practical and safe method for beginners to locate an extraocular muscle, which is as effective as the traditional methods. Botulinum toxin injection can be preferred as the first-line treatment for AACE patients with potential binocular vision.

Treatment of Various Types of Gummy Smile With Botulinum Toxin-A

2019 ◽  
Vol 30 (3) ◽  
pp. 876-878 ◽  
Author(s):  
Onurcem Duruel ◽  
Emel Tuğba Ataman-Duruel ◽  
Ezel Berker ◽  
Tolga Fikret Tözüm
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Toxin A ◽  
Gummy Smile

scholarly journals A Comparative Observational Study to Evaluate the Efficacy of Mid-Urethral Sling with Botulinum Toxin A Injection in Urinary Incontinence Patients

Toxins ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 365 ◽  
Author(s):  
Yi-Huei Chang ◽  
Po-Jen Hsiao ◽  
Huang Chi-Ping ◽  
Hsi-Chin Wu ◽  
Po-Fan Hsieh ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Botulinum Toxin ◽  
Adverse Events ◽  
Observational Study ◽  
Botulinum Toxin A ◽  
Mixed Urinary Incontinence ◽  
Efficacy And Safety ◽  
Toxin A ◽  
Antimuscarinic Agent ◽  
Significant Difference

This study aimed to evaluate and compare the efficacy and safety of mid-urethral sling (MUS) with botulinum toxin A (BoNT-A) versus MUS only in women with mixed urinary incontinence. This was a comparative observational study, and total of 73 patients were enrolled. A total of 38 and 35 patients received MUS only and MUS with BoNT-A injection, respectively. The efficacy outcome included change in Urinary Incontinence Outcome Scores (UIOS), change in Overactive Bladder Symptom Score (OABSS), and use of antimuscarinic agent or beta-3 agonist. Safety assessments included adverse events including urinary retention, increased postvoid residual volumes, and urinary tract infection. MUS with BoNT-A injection was insignificantly better than MUS only in urinary incontinence outcome (88% vs. 71%, respectively, p = 0.085) at week three. Among the 33 patients with detrusor overactivity (DO), patients who received BoNT-A had a higher cure rate of incontinence (88% vs. 41%, p = 0.01) and less required antimuscarinic agent or beta-3 agonist (31% vs. 94%, p < 0.001) compared to patients who did not receive BoNT-A injection. There was no significant difference in the incidences of adverse events between two groups. BoNT-A injection with MUS demonstrated efficacy and safety in the treatment of mixed urinary incontinence, specifically for women with DO.

scholarly journals Therapeutic effect of Botulinum toxin-A in 88 patients with Trigeminal Neuralgia with 14-month follow-up

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Shuang Li ◽  
Ya-Jun Lian ◽  
Yuan Chen ◽  
Hai-Feng Zhang ◽  
Yun-Qing Ma ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Therapeutic Effect ◽  
Botulinum Toxin A ◽  
Toxin A
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