The effect of a combination of clinical crown lengthening surgery and botulinum toxin A injection in gummy smile treatment

Abstract

In many cases, the cause of a gummy smile is not single but a combination of many factors affecting it simultaneously. Therefore, relying on a single method will be difficult to treat comprehensively and achieve the maximum aesthetic requirements for the patient. This study aims to evaluate the efficacy of a combination of a clinical tooth crowns lengthening surgery following by a BTX-A injection in gummy smile treatment upon based on clinical assessment and photography. 21 patients aged from eighteen years with an average length of excessive gingival display ≥ of 4 mm when maximum smiling and the height of keratinized gingiva ≥ 3 mm were recruited. The gingival exposure (GE) and the clinical crown length (CCL) were measured at baseline T0, two months after performing clinical crown lengthening surgery (T1), two weeks after BTX-A injection (T2), two months after BTX-A injection (T3). The GE in individual teeth after crown lengthening surgery (T1) and BTX-A injection after two weeks (T2) and two months (T3) were significantly different (p