Effectiveness of botulinum toxin A, in unraveling gummy smile: A prospective clinical study

Background and Objectives: Gummy smile is a problem in dynamic relationship of the lips to the upper incisors. Different treatment modalities have been used in the past for its correction, which were invasive and time consuming. Recently botulinum toxin A injection has been used as an alternative. This study was aimed at assessing the effect of botulinum toxin type A in the correction of gummy smile. Materials and Methods: Ten patients with the gingival display of more than 3 mm were selected. Photographs were recorded just before the injection, on 14 th , 30 th , 60 th , and 90 th day. 2.5 units of BTX-A was injected under sterile conditions at four sites, two on each side of the face. Software-based measurements were done to minimize errors. Results: Average preinjection gingival display was 4.7+/-1.05 mm. At 2 weeks postinjection, mean gingival display had declined to 0.9+/-0.7 mm, which was statistically very significant; it gradually increased to the average of 3.7 mm on day 90. Discussion: From the study it was inferred that botulinum toxin was very effective in eliminating gummy smile even though the effect was temporary; the effect persisted for only about 3 months