scholarly journals Comparison of Botulinum Toxin and Orthognathic Surgery for Gummy Smile Correction

2020 ◽  
Vol 14 (1) ◽  
pp. 416-420
Author(s):  
Carlos Roberto Dutra ◽  
Paula Patricia Primo ◽  
Daniel Salvatore de Freitas ◽  
Renata Cristina Oliveira ◽  
Ricardo Cesar Gobbi de Oliveira ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Orthognathic Surgery ◽  
Central Incisor ◽  
Upper Lip ◽  
Maxillary Central Incisor ◽  
Incisal Edge ◽  
Intergroup Comparison ◽  
Before And After ◽  
The Difference ◽  
Gummy Smile

Objective: This study aimed to compare the changes in the gummy smile in cases treated with botulinum toxin (BTX) application or orthognathic surgery. Methods: The retrospective sample comprised 61 subjects with gummy smile divided into 2 groups according to treatment received for gummy smile correction: 1-38 patients (6 male; 32 female), at a mean age of 28.60 years (s.d.=6.09), treated with BTX application; 2- 23 patients (7 males and 16 females) at a mean age of 29.59 years (s.d.=5.72) treated with orthognathic surgery. Patients from the BTX group refused to undergo orthognathic surgery. The measurement of the gingival exposure was performed in extraoral photographs of the posed smile, before and after treatment, and it was defined as the difference between the stomion of the upper lip and the incisal edge of the maxillary central incisor minus the height of maxillary central incisor obtained in the patient's dental casts. The data were obtained before (T1) and after treatment (T2) and change of gingival exposure with treatment (T2-T1). Intergroup comparison of gummy smile was performed with independent t-tests. Results: The surgical group presented significantly greater correction of the gummy smile with treatment than the BTX group. Conclusion: Gummy smile presented a greater improvement in patients treated with orthognathic surgery than with botulinum toxin application.

scholarly journals Determination of Maxillary Incisal Edge Position using Canine Visibility as a Guide – An In vivo Study

2021 ◽  
pp. 165-171
Author(s):  
Ankita Piplani ◽  
G. Ganadhipathi ◽  
M. C. Suresh Sajjan
Keyword(s):  
Age Groups ◽  
Adhesive Tape ◽  
Central Incisor ◽  
Upper Lip ◽  
Maxillary Central Incisor ◽  
Group Iii ◽  
Incisal Edge ◽  
Group I ◽  
Group Ii

Purpose:  To evaluate the reliability of the visibility of the central incisor & the canine for the cervico incisal positioning of anterior maxillary teeth related to age & sex while the upper lip was in repose in dentate patients & the development of rehabilitation recommendations for edentulous individuals with regard to the location of the maxillary incisal edge Methodology: 308 subjects [152 Males & 156 Females] belonging to the age of 30 to 59 years were selected using a simple stratified random technique. There were three age and sex groups: Group I was 30 to 39 years old, Group II was 40 to 49 years old, and Group III was 50 to 59 years old. The vertical distances (in mm) between the lower border of the upper lip and the right maxillary central incisal edge and canine tip were measured and recorded using adhesive tape marked with millimetres. A single examiner recorded all the measurements and the values were tabulated and subjected to statistical analysis. Results: Men in Groups I and II had maxillary central incisor exposure ranging from +6 to -1mm, whereas males in Group III had exposure ranging from +5 to -2mm. There was an exposure range of +6 to -2 mm in females in Group I, +7 to -2 mm in Group II, and +5 to -2 mm in Group III for the central incisors. While the canine exposure in Group I and II and Group III ranged from +2 to -4mm in females, the exposure ranged from +3 to -3mm in men of all ages. In all groups, females had statistically significant (P0.05) more central incisor and canine exposure than men. Conclusions: The canine visibility was less variable in all the age groups and in both males and females in comparison to the central incisor. When restoring edentulous individuals, the average canine exposure dimension can be employed for cervico-incisal location of the anterior maxillary teeth.

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 Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

2015 ◽  
Vol 20 (6) ◽  
pp. 52-59
Author(s):  
Guilherme dos Santos Trento ◽  
Felipe Bueno Rosettti Bernabé ◽  
Delson João da Costa ◽  
Nelson Luis Barbosa Rebellato ◽  
Leandro Eduardo Klüppel ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Statistical Tests ◽  
Radiographic Evaluation ◽  
Upper Lip ◽  
Clinical Exposure ◽  
Maxillary Central Incisor ◽  
Maxillary Advancement ◽  
Nasolabial Angle ◽  
Dentofacial Deformities ◽  
Lateral Cephalograms

Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%). Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002). Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

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 Difference in clinical crown length of maxillary central incisors and gingival display at rest and during smiling based on gender

2013 ◽  
Vol 25 (1) ◽  
Author(s):  
Nadia Atina Zaini ◽  
Rasmi Rikmasari ◽  
Lisda Damayanti
Keyword(s):  
Mean Value ◽  
Test Results ◽  
Upper Lip ◽  
Maxillary Central Incisor ◽  
Crown Length ◽  
Anterior Teeth ◽  
Incisal Edge ◽  
Occlusal Wear ◽  
The Mean ◽  
Digital Caliper

Introduction: The aim of the present study was to investigate the effect of gender on the degree of maxillary central incisors and associated gingival display when the lips are at rest and during smiling. Methods: A total of 65 subjects (40 females [61.5%]; 25 males [38.5%]) of Malaysian Malay community studied in UNPAD were included in the study. All of the subjects had all natural anterior teeth present with no caries, extreme occlusal wear, restorations, extrusion, obvious deformities, or tooth mobility. The visible portions of the maxillary central incisor, and associated gingival at rest and smiling were measured vertically from the lower border of the upper lip to the incisal edge of the incisors. The measurements were measured using an electronic digital caliper and repeated three times. The mean value was calculated and statistical analyses were performed by Student t test. Results: Outcome of the study indicated that there is marked difference statistically (p < 0.05) with the clinical crown length display at rest (CCLR). However, the clinical crown length display during smiling (CCLS) and gingival display during smiling (GD) differences is non significant (p > 0.05) between these two genders. Conclussion: Females displayed more clinical crown length of maxillary central incisors than males at rest. During smiling, no gender differences in maxillary central incisors display were recorded, however, females displayed more maxillary gingival than males.

scholarly journals Sagittal Relationship between the Maxillary Central Incisors and the Forehead in Digital Twins of Korean Adult Females

2021 ◽  
Vol 11 (3) ◽  
pp. 203
Author(s):  
Seoung-Won Cho ◽  
Soo-Hwan Byun ◽  
Sangmin Yi ◽  
Won-Seok Jang ◽  
Jong-Cheol Kim ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Three Dimensional ◽  
Careful Consideration ◽  
Control Group ◽  
3D Analysis ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Digital Twins ◽  
Before And After ◽  
Korean Adult

Objective: Digital twins of adult Korean females were created as a tool to evaluate and compare the sagittal relationship between the maxillary central incisors and the forehead before and after orthodontic treatment. Methods: Digital twins were reconstructed for a total of 50 adult female patients using facial scans and cone-beam computed tomography (CBCT) images. The anteroposterior position of the maxillary central incisor and the forehead inclination were measured. Results: The control group presented a mean of 6.7 mm for the sagittal position and 17.5° for forehead inclination. The study group showed a mean of 9.3 mm for the sagittal position and 13.6° for forehead inclination. Most Korean females seeking orthodontic treatment had their maxillary central incisor anterior to the glabella. In contrast, fewer Korean females who completed their orthodontic treatments had their maxillary central incisor anterior to the glabella. Furthermore, patients who had completed the orthodontic treatment were more likely to have the maxillary central incisor between the forehead facial axis and glabella. Conclusion: The use of digital twins for three-dimensional (3D) analysis of the profile implies a high clinical significance. In addition, as the facial profile of Koreans is different from that of Caucasians, careful consideration should be made when setting treatment goals for the anteroposterior position of the maxillary central incisors.

scholarly journals Botulinum Toxin for the Treatment of Gummy Smile

2017 ◽  
Vol 18 (6) ◽  
pp. 474-478 ◽  
Author(s):  
Afnan F Al-Fouzan ◽  
Lamia S Mokeem ◽  
Reem T Al-Saqat ◽  
Maisa A Alfalah ◽  
Mana A Alharbi ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Neuromuscular Disorders ◽  
Type I ◽  
Lower Margin ◽  
Female Patients ◽  
Dermatology Clinic ◽  
Before And After ◽  
The Mean ◽  
Gummy Smile

ABSTRACT Aim The aim was to evaluate the effect of botulinum toxin (Botox) injections as a conservative treatment for gummy smile. Materials and methods An experimental in vivo study was conducted at a dermatology clinic in Riyadh in January 2016. The study included 23 female patients who ranged from 20 to 50 years and were treated with Botox injections due to excessive maxillary gingival display. The patients with short clinical crowns or long maxilla, those who were pregnant or breastfeeding, and patients with neuromuscular disorders were excluded. Patients received Botox type I, injected 3 mm lateral to the alar-fascial groove at the level of the nostril opening at the insertion of the levator labii superioris alaeque nasi muscle. Photos were taken of the patient's smile before and after the treatment and were then uploaded to the SketchUp program to calculate improvements in gingival display. The distance from the lower margin of the upper lip to the gingival margin was calculated pre- and posttreatment. The amount of improvement was calculated as (pre-Botox treatment – post-Botox treatment/pre-Botox treatment × 100). The mean percentage of the total improvement was analyzed. Results A total of 23 female patients received treatment to improve their gummy smile. Improvement was clear 2 weeks after Botox injection. The mean percentage of improvement in the gingival display was 99.6%. Conclusion Botox type I is an effective conservative technique to improve gummy smile caused by muscular hyperfunction. Clinical significance Patients’ retention highly indicated that they were satisfied with the provided treatment by Botox injections. Improving the quality of life with least painful experience and immediate results was the major advantage for Botox type I. How to cite this article Al-Fouzan AF, Mokeem LS, Al-Saqat RT, Alfalah MA, Alharbi MA, Al-Samary AE. Botulinum Toxin for the Treatment of Gummy Smile. J Contemp Dent Pract 2017;18(6):474-478.

scholarly journals Dental displacement in complete dentures influenced by different flask types and polymerization cycles

2021 ◽  
Vol 32 (2) ◽  
pp. 64-71
Author(s):  
Conrado Reinoldes Caetano ◽  
Ricardo Armini Caldas ◽  
Anna Gabriella Camacho Presotto ◽  
Valentim Adelino Ricardo Barão ◽  
Ataís Bacchi ◽  
...  
Keyword(s):  
Digital Camera ◽  
Boiling Water ◽  
Complete Dentures ◽  
Similar Difference ◽  
Incisal Edge ◽  
Before And After ◽  
The Difference

Abstract This study evaluated the dental displacement in dentures included in different flasks and processed by the Australian cycle modified or by microwave. Metal pins were placed on the teeth as reference for measurements: a) Incisal edge of maxillary and mandibular central incisors, buccal cusp of maxillary and mandibular vestibular first premolars, and mesiobuccal maxillary and mandibular cusps of second molars; b) Incisor to incisor, premolar to premolar and molar to molar; c) Left incisor to left molar and right incisor to right molar, and d) Vertical. Dentures were divided according to flasks (n=10): G1- Metal; G2- HH bimaxillary metal; G3-Microwaves; G4- HH bimaxillary microwaves. For G1 and G2, polymerization at 65ºC/30 min, flame quenched for 30 min, heating at 65ºC/30 min, boiling water for 1 h. For G3 and G4, microwave (20 min/140 W and 5 min/560 W). Comparator microscope with digital camera and analytical unit assessed the measurements before and after denture polymerization. The final distance was made subtracting the distance before the denture processing from the distance of the dental displacement after processing. The value of the difference was submitted to 2-way ANOVA, considering the flask type and denture type. Maxillary denture showed greater displacement when compared to mandibular denture. Flask types and interaction with denture types showed similar difference between before and after polymerization. In conclusion, displacement promoted by flask types in dentures cured by polymerization cycles promoted similar effect on the distance between teeth. Greater value for distance between teeth occurred for maxillary denture.

Comparison between diode laser and scalpel for lip lengthening in patients with gummy smile

2019 ◽  
Vol 31 (1) ◽  
pp. 60-64
Author(s):  
Alan H Mawlood Qassab ◽  
Shehab A Hamad
Keyword(s):  
Clinical Study ◽  
Diode Laser ◽  
Wound Dehiscence ◽  
Upper Lip ◽  
Comparative Clinical Study ◽  
Surgical Options ◽  
Laser Group ◽  
The Difference ◽  
Infiltration Anesthesia ◽  
Gummy Smile

Background: lip lengthening procedure is one of the surgical options for the correction of gummy smile in patients with short upper lip. Methods: A comparative clinical study was conducted on 15 patients requiring lip lengthening procedure for the esthetic correction of excessive gingival exposure with gummy smile. Scalpel was used in seven patients and diode laser in the remaining eight patients. Under infiltration anesthesia, about one cm strip of mucosa was excised at the vestibular depth and the mucosa of the lip was sutured to the alveolar mucosa. Results: The diode laser group demonstrated less postoperative pain and swelling. Regarding postoperative ecchymosis, three patients in the scalpel group developed ecchymosis and no cases were noted in the laser group, the difference was statistically significant. No patient in the laser group developed wound dehiscence and only one patient in the scalpel group had wound dehiscence at third postoperative day. Observed at one month postoperatively, the laser treated groups had less obvious scar than the scalpel group. Conclusion: Diode laser is a valuable tool in performing lip lengthening for gummy smile.

scholarly journals A Comparative Evaluation of Effect of Upper Lip Length, Age and Sex on Amount of Exposure of Maxillary Anterior Teeth

2011 ◽  
Vol 12 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Paranjay Prajapati ◽  
Rajesh Sethuraman ◽  
YG Naveen
Keyword(s):  
Comparative Evaluation ◽  
Age Group ◽  
Central Incisor ◽  
Upper Lip ◽  
Maxillary Central Incisor ◽  
Anterior Teeth ◽  
Relationship Of ◽  
The Relationship ◽  
Male Subjects ◽  
Age And Sex

ABSTRACT Aim The aim was to evaluate the relationship of age, sex and lip length to the amount of exposure of maxillary incisors and canine teeth. Materials and methods Two-hundred subjects were enrolled in the study. All subjects were grouped according to the lip length and age. The exposure of maxillary central incisor and canines was measured with flexible millimeter ruler. Teeth exposure beyond the lower border of the upper lip was considered as positive exposure and the unexposed teeth were considered as negative exposure. Result In females of age group 20 to 29, 30 to 39, 40 to 49 and 50 to 59 years, the mean exposure of central incisor was 2.16, 2.1, 2.18 mm and that of canine was 0.04, −0.36, −0.44 mm. For male of age group 20 to 29, 30 to 39, 40 to 49 and 50 to 59 years exposed 2.04, 2.04, 1.84, 1.76 mm of central incisor respectively and 0.08, −0.52, −0.4 and −0.4 mm exposure of canine. Female subjects with lip length 10 to 15, 15 to 20, 21 to 25, 25 to 30 and 31 to 35 mm showed 3.7, 3.4, 2.3, 0.9, 0.25 mm exposure of central incisor and 0.35, −0.15, −0.7, −0.8, −0.6 mm exposure of canine, respectively. Male subjects exposed 3.4, 3.3, 2.05, 0.7, 0.15 mm of central incisor and 0.4, 0.3, −0.6, −0.95, −0.7 mm of canine respective to lip length. Conclusion The range of exposure of maxillary central incisors was wider than that of canine. The average dimensions for maxillary canines relating to age and sex were closer to the extremes of the range. The canine position relative to the maxillary lip appeared to be a more predictable determinant. Clinical significance The result of the study can be used as a reference according to the age, sex and the lip length of the patient to correctly place maxillary anterior teeth in prosthesis. How to cite this article Patel JR, Prajapati P, Sethuraman R YG N. A Comparative Evaluation of Effect of Upper Lip Length Age and Sex on Amount of Exposure of Maxillary Anterior Teeth. J Contemp Dent Pract 2011;12(1):24-29.

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