scholarly journals Smile — one of the important elements of face aesthetics

2019 ◽  
Vol 2 (2) ◽  
pp. 101-110
Author(s):  
Patrycja Przybylska ◽  
Tomasz Siniecki ◽  
Teresa Matthews‑Brzozowska
Keyword(s):  
Botulinum Toxin ◽  
Maximum Effect ◽  
Upper Lip ◽  
First Case ◽  
Patient Reported ◽  
Levator Labii Superioris ◽  
The Face ◽  
Gummy Smile

The harmony of the smile depends not only on the dentition, but also on the gum tissue, which excessively exposed can negatively affect aesthetics of the smile. Exposure of a small amount of gum during a smile is acceptable however a smile in which the exposure of the gum is more than 2 mm is considered an aesthetic defect called gummy smile. Among the causes of gingival smile listed are: shortened or hyperactive upper lip muscles (levator labii superioris, levator labii superioris alaeque nasi, zygomatic minor muscles), vertical maxillary excess, extrusion of alveolar ridges, altered passive eruption. In the case of hyperactive upper lip muscles, botulinum toxin can be used — this procedure was used in the described cases, and the effects were assessed using the FotoMedicus system and measurements of gingival exposure. In first case Bocouture botulinum toxin was administered on both sides, 4 units bilaterally in the levator labii superioris muscle and 2 units into levator anguli oris muscle. In total, 12 units were given. During the follow‑up the patient reported the start of the effect from the 5th day after the supply with the maximum effect after 12 days. A 6 mm correction of gummy smile was achieved. In the second case 4 units of botulinum toxin were applicated bilaterally into levator labii superioris alaeque nasi muscle. A 3 mm correction of gummy smile was achieved. The aesthetics of the face in a smile definitely improved in both men.

scholarly journals Chondroid syringoma of the upper lip: a rare entity

2020 ◽  
Vol 6 (10) ◽  
pp. 1900
Author(s):  
Ashiya Goel ◽  
Aman . ◽  
Vinny Raheja ◽  
Manisha Kumari
Keyword(s):  
Differential Diagnosis ◽  
Normal Tissue ◽  
Neck Region ◽  
Rare Entity ◽  
Upper Lip ◽  
Head And Neck Region ◽  
Chondroid Syringoma ◽  
The Face ◽  
Slow Growing

<p class="abstract"><span lang="EN-US">Chondroid syringomas are uncommon cutaneous neoplasms of sweat gland origin which are slow-growing, nontender, subcutaneous or intracutaneous in location and often occurring in the head and neck region. Chondroid syringoma should be considered in the differential diagnosis of any subcutaneous nodule over the face. The clinician may miss the diagnosis of this lesion and if it is suspected, tumour should be excised with a margin of normal tissue and regular follow up should be done.</span></p>

Periodontia, Estética Orofacial e o Tratamento Multidisciplinar do Sorriso Gengival: Relato de Caso

REVISTA FIMCA ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 72-80
Author(s):  
Christiane Mayara Couto Louzada Neves Silva ◽  
Andrea Damas Tedesco ◽  
Davi Silva Barbirato ◽  
Mariana Fampa Fogacci
Keyword(s):  
Computed Tomography ◽  
Botulinum Toxin ◽  
Cone Beam Computed Tomography ◽  
Botulinum Toxin Type A ◽  
Multidisciplinary Treatment ◽  
Botulinum Toxin Type ◽  
Cone Beam ◽  
Patient Reported ◽  
Satisfaction With Treatment ◽  
Gummy Smile

Introdução: O sorriso gengival, ocorre durante a fala ou sorriso espontâneo, quando há aparência de mais de três milímetros de gengiva, tornando-se desarmônica a relação entre a proporção de dentes, lábios e gengivas. Nesses casos, o tratamento seria o aumento de coroa clínica, seguido ou não de aplicação de toxina botulínica do tipo A, dependendo do diagnóstico. Ferramentas como o Planejamento Digital do Sorriso e a Tomografia Computadorizada Cone Beam com afastadores labiais, são recursos atuais que possibilitam um bom e completo planejamento dos casos de sorriso gengival. Associando-se ambas as técnicas para o planejamento, o tratamento de correção do sorriso gengival torna-se mais simples e previsível. Objetivos: A presente pesquisa teve por objetivo reportar um caso clínico de sorriso gengival de etiologia múltipla, em que o planejamento e o tratamento foram multidisciplinares. Relato do Caso: Paciente do sexo feminino, 19 anos de idade, compareceu à Clínica de Odontologia da Faculdades Integradas Aparício Carvalho – FIMCA, com queixa de sorriso gengival, e desproporção de tamanho das coroas dos incisivos centrais superiores. Foram realizados anamnese, exame clínico e exame periodontal, tomografia computadorizada e planejamento digital do sorriso. Após minucioso planejamento foi inidicada a cirurgia de aumento de coroa clínica e a aplicação de toxina botulínica. Paciente, relatou satisfação pelo tratamento e novo sorriso. Conclusão: Quando se trata de estética do sorriso, é essencial um bom planejamento. O Planejamento Digital e a Tomografia Computadorizada Cone Beam com afastadores labiais são ferramentas fundamentais para os casos de sorriso gengival. Optar pelo tratamento multidisciplinar, avaliando a estética orofacial seré sempre mais seguro e com resultados precisos, previsíveis e satisfatórios. Introduction: The gummy smile, occurs during speech or spontaneous smile, when there is appearance of more than three millimeters of gingiva, making disharmonious the relation between the proportion of teeth, lips and gums. In these cases, the treatment would be the clinical crown increase, followed or not by the application of botulinum toxin type A, depending on the diagnosis. Tools such as Digital Smile Design and Cone Beam Computed Tomography with lip retractors are current features that enable good and complete planning of gummy smile cases. By associating both techniques in the planning, gingival smile correction treatment becomes simpler and predictable. Objectives: The present study aimed to report a clinical case of gummy smile of multiple etiology, in which planning and treatment were multidisciplinary. Case Report: A 19-year-old female patient attended the Dental Clinic of Faculdades Integradas Apari?cio Carvalho - FIMCA, with complaint of gummy smile, and disproportion of crown size of the upper central incisors. Anamnesis, clinical examination and periodontal examination, computed tomography and digital smile planning were performed. After careful planning, clinical crown augmentation surgery and the application of botulinum toxin were instituted. Patient reported satisfaction with treatment and new smile. Conclusion: When it comes to smile aesthetics, good planning is essential. Digital Smile Design and Cone Beam Computed Tomography with lip retractors are fundamental tools for gingival smile cases. Opting for multidisciplinary treatment, evaluating orofacial aesthetics will always be safer and will bring accurate, predictable and satisfactory results.

scholarly journals Clinical and electromyographic evaluation of botulinum toxin type A in the treatment of gummy smile: A prospective clinical study

2021 ◽  
Vol 15 (2) ◽  
pp. 122-128
Author(s):  
Payal Padmakar Mate ◽  
Kumar Nilesh ◽  
Anand Joshi ◽  
Arun Panda
Keyword(s):  
Botulinum Toxin ◽  
Clinical Study ◽  
Repeated Measures ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Prospective Clinical Study ◽  
Upper Lip ◽  
The Mean ◽  
Gummy Smile

Background. The present study aimed to assess the effect of botulinum toxin type A (BTX-A) for the management of gummy smile and evaluate its stability after administrating BTX-A clinically and using electromyography. Methods. The investigators designed and implemented a prospective clinical study on 10 patients with a gummy smile. Patients with different types of gummy smile were injected with BTX-A in the levator muscles of the upper lip and were followed for six months. The effect of BTX-A was evaluated clinically and using electromyography preoperatively and after two weeks and three and six months. Statistical analyses were carried out using repeated measures ANOVA and post hoc Bonferroni tests for pairwise comparisons. Results. The sample consisted of 10 patients with an anterior gummy smile (n=3), posterior gummy smile (n=2), mixed gummy smile (n=3), and asymmetrical gummy smile (n=2). There were significant differences (P<0.001) between the mean gingival display and compound muscle action potential at two-weeks and three-month follow-ups. The maximum result was obtained at the two-week interval. The mean gingival display and C-MAP values increased slightly at the three-month postoperative interval and gradually increased to the baseline values at six-month follow-up. Conclusion. BTX-A is an effective, minimally invasive, and temporary treatment modality for gummy smiles. The electromyographic study is a convenient method for assessing changes in the upper lip muscle contractility to quantify the effect of BTX-A in the treatment of gummy smile.

scholarly journals Surface Anatomy of the Lip Elevator Muscles for the Treatment of Gummy Smile Using Botulinum Toxin

2009 ◽  
Vol 79 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Woo-Sang Hwang ◽  
Mi-Sun Hur ◽  
Kyung-Seok Hu ◽  
Wu-Chul Song ◽  
Ki-Seok Koh ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Clinical Effectiveness ◽  
Injection Point ◽  
Surface Anatomy ◽  
Morphologic Characteristics ◽  
Triangular Region ◽  
Levator Labii Superioris ◽  
Facial Midline ◽  
Gummy Smile

Abstract Objective: To propose a safe and reproducible injection point for botulinum toxin-A (BTX-A) as a supplementary method for the treatment of gummy smile, as determined by assessment of the morphologic characteristics of three lip elevator muscles. Materials and Methods: A total of 50 hemi-faces from 25 adult cadavers (male 13, female 12; ages, 47 to 88 years) were used in this study. Topographic relations and the directions of the lip elevator muscles (ie, levator labii superioris [LLS], levator labii superioris alaeque nasi [LLSAN], and zygomaticus minor [ZMi]), were investigated. Possible injection points were examined through the study of predetermined surface landmarks. Results: The insertion of the LLS was covered partially or entirely by the LLSAN and the ZMi, and the three muscles converged on the area lateral to the ala. The mean angle between the facial midline and each muscle vector was 25.8 ± 4.8 degrees for the LLS, 55.7 ± 6.4 degrees for the ZMi, and −20.2 ± 3.2 degrees for the LLSAN; no significant differences were noted between male and female subjects or between left and right sides. The three vectors passed near a triangular region formed by three surface landmarks. The center of this triangle, named the “Yonsei point”, was suggested as an appropriate injection point for BTX-A. The clinical effectiveness of the injection point was demonstrated in selected cases with or without orthodontic treatment. Conclusions: Under careful case selection, BTX-A may be an effective treatment alternative for patients with excessive gingival display caused by hyperactive lip elevator muscles.

Predictability in Lip Repositioning with Botulinum Toxin for Gummy Smile Treatment: A 3-Year Follow-up Case Series

2020 ◽  
Vol 40 (5) ◽  
pp. 703-709
Author(s):  
Andrea Vergara-Buenaventura ◽  
Frank Mayta-Tovalino ◽  
Albert Correa ◽  
Erin Breen ◽  
Gerardo Mendoza-Azpur
Keyword(s):  
Botulinum Toxin ◽  
Case Series ◽  
Gummy Smile

Physiotherapy and Botulinum Toxin Injections Prior to Stabilization Surgery for Recurrent Atraumatic Anteroinferior Shoulder Dislocation with Abnormal Muscle Patterning

2012 ◽  
Vol 4 (4) ◽  
pp. 287-290 ◽  
Author(s):  
Clare P. Donnellan ◽  
Martin A. Scott ◽  
Mary Antoun ◽  
W. Angus Wallace
Keyword(s):  
Botulinum Toxin ◽  
Shoulder Instability ◽  
Shoulder Dislocation ◽  
Marked Improvement ◽  
Latissimus Dorsi ◽  
Shoulder Stabilization ◽  
Patient Reported ◽  
Teres Major ◽  
Botulinum Toxin Injections

Shoulder instability is a complex phenomenon and repeated dislocation due to persistent abnormal muscle patterning can be challenging to manage. This case report describes the treatment of a 21-year old female who presented with repeated atraumatic anteroinferior shoulder dislocation due to abnormal muscle patterning. Management involved physiotherapy to re-educate muscle control combined with botulinum toxin injections into pectoralis major, latissimus dorsi and teres major prior to shoulder stabilization surgery. The patient reported marked improvement as reflected by improved scores on the Oxford Shoulder Instability Score and Western Ontario Shoulder Instability Score. Benefits were maintained at 3 year follow-up.

scholarly journals Modifying Gummy Smile: A Minimally Invasive Approach

2014 ◽  
Vol 15 (6) ◽  
pp. 821-826 ◽  
Author(s):  
Walid Ahmed Abdullah ◽  
Hesham S Khalil ◽  
Maryam M Alhindi ◽  
Hamdy Marzook
Keyword(s):  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Invasive Procedure ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Lower Position ◽  
Surgical Methods ◽  
Levator Labii Superioris ◽  
Gummy Smile

ABSTRACT Aim Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile. Materials and methods Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit. Results At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month. Conclusion This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile. Clinical significance A non-invasive procedure to avoid other complicated surgical procedures. How to cite this article Abdullah WA, Khalil HS, Alhindi MM, Marzook H. Modifying Gummy Smile: A Minimally Invasive Approach. J Contemp Dent Pract 2014;15(6):821-826.

The Nasolabial Fold: Applied Surgical Anatomy and Histology

1991 ◽  
Vol 8 (4) ◽  
pp. 217-221 ◽  
Author(s):  
Lee R. Walker ◽  
Steven Mudrovich ◽  
Bruce N. Epker
Keyword(s):  
Subcutaneous Fat ◽  
Surgical Techniques ◽  
Surgical Anatomy ◽  
Nasolabial Fold ◽  
Upper Lip ◽  
Facial Surgery ◽  
Nasal Ala ◽  
Levator Labii Superioris ◽  
The Face ◽  
Fresh Frozen

In aesthetic facial surgery, the nasolabial fold is the most resilient to attempts at its surgical correction. Numerous surgical techniques have been employed, but none produce satisfying and lasting results. Therefore, a more thorough evaluation of the surgical anatomy and histology of the nasolabial fold was undertaken in order to seek improved methods for its correction. Four cadaver heads, three fresh-frozen and one preserved, were bilaterally dissected and studied anatomically and histologically. The most demonstrable anatomic feature was an abundance of fat superior to the nasolabial fold crease, which became thin and almost nonexistent inferior to the crease in the upper lip. Second, the fold was entirely confined to the subcutaneous fat layer of the face. Along the superior half of the nasolabial fold crease, adjacent to the nasal ala, the crease was directly attached to the nasalis and levator labii superioris muscles. This attachment of skin to underlying muscle, continued throughout the upper lip. In addition, the SMAS could not be dissected from other fascial layers in the area of the nasolabial fold, and the only surgical plane of dissection that exists in the nasolabial fold area was in the subcutaneous plane superficial to the muscular layer.

scholarly journals Osteochondroma Involving the Ramus of the Mandible: An Unusual Location

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Pakki Suresh Kumar ◽  
Dola Srinivasa Rao ◽  
Swapna Manepalli ◽  
Ajit Damera ◽  
Jai Kiran Killada
Keyword(s):  
Histopathological Examination ◽  
Mouth Opening ◽  
Panoramic Radiograph ◽  
Axial Skeleton ◽  
Patient Reported ◽  
The Face ◽  
Magnetic Resonance Imaging Mri ◽  
One Year ◽  
The One

Osteochondroma (OC) is considered the most common tumor of the axial skeleton, although it is relatively uncommon in the craniofacial region. The present case describes an atypical case of OC in the posterior border of the ramus of the mandible. To the best of our knowledge, only one case has been reported till now in this region. A 35-year-old male patient reported with a complaint of swelling over the left middle one-third of the face and limited mouth opening for six years. Panoramic radiograph (PR) and paranasal sinus (PNS) view showed a well-defined radiopacity located in this region. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a characteristic mushroom-shaped outgrowth from the inner surface of the ramus of the mandible. The patient was treated with osteotomy, with the cut made at the angle of the mandible. Histopathological examination revealed features suggestive of OC. Subsequently, the patient was able to open his mouth, and there was no evidence of recurrence or postoperative complications in the one-year follow-up.

Sign in / Sign up

Export Citation Format

Share Document