Abstract

Objectives: * To gain the ability to assess different smile patterns and different types of gummy smile. * To be able to customize your injection points depending on the type of gummy smile. * To use a standardized approach for the dosage when you treat the gummy smile Introduction: The present study was performed to evaluate the effect of repeated botulinum toxin injections and their long-term effects, using a customized injection point and dosage technique in the treatment of excessive gingival display. Materials / method: Twenty women who had gummy smile due to hypermobility of the upper lip or gingival display, ranging from 4 to 6 mm‚ were included in the study. All patients were injected with Botox injections at different injection points according to the type of smile. Pre- and postoperative measurements were taken by measuring digitally the gingival display at smiling, using Adobe Photoshop software via standardized digital photographs. Patients were followed up at 14 days, 4 months, 8 months, and 12 months. Results: Postoperative measurements showed marked improvement at 14-day follow-up, with a significant reduction in the amount of gingival display. Relapse, however, occurred at 4 months and later. Conclusion: For excessive gingival display, Botox is an effective treatment that lasts for 2–3 months, with almost complete relapse at 4 months. We concluded from the results of our study that, despite repeated Botox injections at two follow-up intervals (4 and 8 months), the theory that repeated Botox injections may offer a permanent effect is still questionable.