Botulinum toxin in the treatment of gummy smile

A gummy smile is an excessive exposure of the gums while smiling. There are four types: anterior- excessive gum exposure from canine to canine, posterior — excessive gum exposure in the lateral segment, mixed — combining the anterior and posterior components, and asymmetrical — with a disproportion between the right and left side. The causes of gingival smile include: skeletal defect, delayed passive tooth eruption, nasal septal dysplasia, and excessive muscle activity. A simple, fast and minimally invasive method of gummy smile therapy caused by excessive muscle activity is the supply of botulinum toxin type A to the muscles responsible for a given type of smile. A favorable aesthetic effect can be achieved with a good knowledge of application sites and individually selected doses. When determining the dose, which is described in the literature between 2 IU and 10 IU onabotulin per page, researchers take into account not only the type of corrected smile, the number of puncture points, but also gender and age of the patient.

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Botulinum toxin type A for the treatment of muscle contractures secondary to acute spinal cord injury in a young cat

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116920922648 ◽

2020 ◽

Vol 6 (1) ◽

pp. 205511692092264

Author(s):

Robert I McGeachan ◽

Tobias Schwarz ◽

Danièlle A Gunn-Moore ◽

Katia Marioni-Henry

Keyword(s):

Spinal Cord ◽

Botulinum Toxin ◽

Botulinum Toxin Type A ◽

Clinical Signs ◽

Type A ◽

Botulinum Toxin Type ◽

Subacute Stroke ◽

Thoracic Limb ◽

Cord Injury ◽

The Right

Case summary A 4-month-old male entire domestic shorthair cat presented for sudden onset of right thoracic monoparesis following a fall; within 18 h, the clinical signs progressed to non-ambulatory right hemiplegia with absent sensation in the distal right thoracic limb and left hemiparesis. MRI revealed changes consistent with a C6–C7 acute non-compressive nucleus pulposus extrusion with suspected secondary C5–C7 spinal cord haemorrhage. Rehabilitation exercises were started immediately after the diagnosis of acute spinal cord trauma. Sensation in the right thoracic limb improved and, with the help of a splint applied to that limb, the cat was ambulatory on all four limbs. Unfortunately, clinical signs started to progress over the course of 10 days. The cat developed progressive discomfort on manipulation of the right elbow and carpus, and a hyperflexion of the right carpus. Radiographs revealed no skeletal abnormalities. Muscle contractures were suspected. Under general anaesthesia the triceps and flexor muscles of the carpus and digits were injected with a total of 100 U of botulinum toxin type A (BTX-A). No complications were associated with the procedure and 24 h after the injection the carpal hyperflexion resolved. Relevance and novel information The use of BTX-A to treat muscle contractures in human medicine is an established and increasingly used technique. For example, in subacute stroke patients with a non-functional arm, BTX-A forearm injection appears to prevent disabling finger stiffness, likely by minimising the development of contractures. Here, we demonstrate that intramuscular BTX-A is an effective treatment for acquired muscle contractures in a cat.

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Current Strategies in the Treatment of Gummy Smile Using Botulinum Toxin Type A

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e31824f00a6 ◽

2012 ◽

Vol 129 (6) ◽

pp. 1015e ◽

Cited By ~ 4

Author(s):

Alessandro Mangano ◽

Alberto Mangano

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Gummy Smile

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

REVISTA FIMCA ◽

10.37157/fimca.v4i1.11 ◽

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.

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Is it clinically effective to treat arm flexor spasticity, with Botulinum toxin - type A (BoNTA) and physiotherapy, as soon as signs of abnormal muscle activity are observed

http://isrctn.org/> ◽

10.1186/isrctn57435427 ◽

2012 ◽

Author(s):

Cameron Lindsay

Keyword(s):

Botulinum Toxin ◽

Muscle Activity ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type

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Therapeutic effects of botulinum toxin type A in subjects with gummy smile: A longitudinal sEMG approach

International Orthodontics ◽

10.1016/j.ortho.2021.07.004 ◽

2021 ◽

Author(s):

Adilson Tolfo de Oliveira ◽

Sylvia de Araújo Paes-Souza ◽

Marco Antonio Cavalcanti Garcia ◽

Claudia Trindade Mattos ◽

Matilde da Cunha Gonçalves Nojima

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Therapeutic Effects ◽

Gummy Smile

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Management of unilateral idiopathic masseter muscle hypertrophy with botulinum toxin type A

BMJ Case Reports ◽

10.1136/bcr-2020-239056 ◽

2021 ◽

Vol 14 (1) ◽

pp. e239056

Author(s):

Kumar Nilesh ◽

Ravina Dharamsi ◽

Pankaj Patil ◽

Payal Mate

Keyword(s):

Botulinum Toxin ◽

Masseter Muscle ◽

Muscle Hypertrophy ◽

Botulinum Toxin Type A ◽

Unknown Origin ◽

Type A ◽

Botulinum Toxin Type ◽

Facial Aesthetics ◽

Invasive Method ◽

Bone Injection

Masseter hypertrophy (MH) is an uncommon disorder which can cause both aesthetic and functional problems. The most common aetiological factors associated with MH are habit of chewing gum, clenching and/or bruxism. The treatment of MH includes conservative management as well as surgical resection of the enlarged muscle and/or bone. Injection of botulinum toxin type A is a relatively new and minimally invasive method for management of masseter muscle hypertrophy, which offers many advantages over conventional surgical management. This paper reports a case of unilateral MH of unknown origin which was treated with injection of botulinum toxin type A, resulting in satisfactory reduction in the volume of muscle and improvement of facial aesthetics.

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

Journal of Dental Research Dental Clinics Dental Prospects ◽

10.34172/joddd.2021.021 ◽

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.

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