Efficacy of combining clinical crown lengthening surgery and botulinum toxin A injection in gummy smile treatment

Abstract

In many cases, the cause of a gummy smile is a combination of many simultaneously occurring factors. Therefore, a single method is certainly not effective in achieving the maximum aesthetic requirements. This study aims to evaluate the efficacy of combining clinical tooth crown lengthening surgery and subsequent BTX-A injection in gummy smile treatment using clinical and photographical assessment. 21 patients with an average length of excessive gingival display of at least 4 mm at maximum smiling point and with the height of keratinized gingiva ≥ 3 mm were recruited. Gingival exposure (GE) and clinical crown length (CCL) were measured at baseline (T0), two months after clinical crown lengthening surgery (T1), two weeks after BTX-A injection (T2), two months after BTX-A injection (T3). GE values at T1, T2 and T3 were significantly different (p <0.001). CCL was significantly changed after gingivectomy surgery (T1) compared to preoperative value (T0) (p <0.001). BTX-A could be considered a favorable adjunctive treatment for gummy smile patients after gingivectomy surgery.