GUMMY SMILE TREATMENT WITH BOTULINUM TOXIN AND REVIEW OF LITERATURE- A CASE REPORT

Yıl 2015, Supplement 11, 4 - 7, 07.10.2015

Melike Öztürk , Yerda Özkan Recep Orbak

https://doi.org/10.17567/dfd.02080

Öz

Aim: In this case report, Botulinum Toxin’s application methods, advantages, disadvantages, indications and contraindications are discussed at the literacy. Case and Method: A 29-year-old woman came to our clinic with the complain of excessive gingival display on smiling. She was systemically healthy and she had no drug usage. 5 mm of gingival display When smiling was diagnosed. After clinical examination, it was recorded that her gummy smile was due to hyperactive lip elevator muscles. Botulinum Ireland) is applied according to manifacturer’s instructions. Results: After 1 week of the Botulinum Toxin injection the excessive gingival exposure is decreased 3.5 mm at the patient. Conclusion: Gummy smile(GS) is an aesthetic disorder for some patients that is seen due to several factors which has some different treatment options such as orthognatic surgery, orthodontic treatment, gingivoplasty and bone resection. Latterly, Botulinum Toxin,is also being used at gummy smile cases as a minimal invasive treatment alternative to decrease excessive gingival display

Anahtar Kelimeler

Botulinum toxin, botox, gingival exposure, gummy smile

BOTULİNUM TOKSİNLE GUMMY SMİLE TEDAVİSİ VE LİTERATÜR DERLEMESİ- OLGU SUNUMU

Öz

Amaç: Bu olgu sunumunda, Botulinum Toksinin uygulama yöntemi, avantajları, dezavantajları,  endikasyonları ve kontrendikasyonları literatür bilgileri ışığında incelenecektir. Olgu ve Yöntem: 29 yaşında bayan hasta kliniğimize fazladan gingival görünüm şikayetiyle başvurdu. Hasta sistemik olarak sağlıklıydı ve herhangi bir ilaç kullanımı bulunmamaktaydı. Gülümseme esnasında hastada 5 mm dişeti görünümü tespit edildi. Klinik muayeneden sonra, gummy smile sebebinin hiperaktif elevator kaslar sebebiyle olduğu gözlendi. Botulinum Toksin(Botox;Allergan Inc. Westport, İrlanda) üreticinin talimatlarına göre uygulandı.  Bulgular: Botulinum Toksin enjeksiyonu sonrasında hastada gingival görünüm 3.5 mm azaldı. Sonuç: Gummy smile(GS) birkaç neden ötürü görülen; ortognatik cerrahi, ortodontik tedavi, gingivoplasti ve kemik rezeksiyonu olmak üzere farklı tedavi seçenekleri mevcut olan estetik bir bozukluktur. Son zamanlarda, Botulinum Toksin gummy smile vakalarında minimal invaziv bir tedavi seçeneği olarak kullanılmaktadır.

Anahtar Kelimeler

Botulinum Toksin, botoks, gingival görünüm, gummy smile

Kaynakça

• Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000 1996;11: 18-28.
• Gill DS, Naini FB, Tredwin CJ. Smile aesthetics. SADJ 2008; 63:272-5.
• Davis NC. Smile design. Dent Clin North Am 2007; 51:299-318.
• Armitage, GC. Development of a classification system for periodontal disease and conditions. Annals of Periodontology 1999; 4: 1–6.
• Tjan AH, Miller, GD,The JG. Some esthetic factors in a smile. The Journal of Prosthetic Dentistry 1984; 51: 24–8.
• Dong, JK, Jin TH, Cho, HW. Oh, SC. The esthetics of the smile: a review of some recent studies. International JProsthodontics 1999; 12: 9–19.
• Peck, S., Peck, L. & Kataja, M. The gingival smile line. The Angle Orthodontist 1992; 62: 91–100.
• Ezquerra F, Berrazueta MJ, Ruiz-Capillas A, Arregui JS. New approach to the gummy smile. Plast Reconstr Surg 1999; 104: 1143–50.
• Silberberg N, Goldstein M, Smidt A. Excessive gingival diagnosis, display–etiology, modalities. Quintessence Int 2009; 40: 809–18.
• Brin MF, Hallett M, Jankovic J. Preface. In: Brin MF, Hallet M, Jankovic J, editors. Scientific and therapeutic aspects of botulinum toxin. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 223-32 .
• Comella CL. Cervical dystonia: treatment with 21. Simon Z, Rosemblatt A, Dorfmann W. Eliminating a botulinum toxin serotype A as Botox® or Dysport®. In: Brin MF, Hallet M, Jankovic J, editors. Scientific and therapeutic aspects of botulinum toxin. 22. Niamtu III J. Botox injections for gummy smiles. Am Philadelphia: Lippincott Williams and Wilkins; 2002. p. 359-64.
• Blitzer A, Zalvan C, Gonzalez-Yanez O, Brin MF. Botulinum toxin type A injections for the management of the hyperfunctional larynx. In: Brin 24. Carruthers A, Carruthers J, Flynn TC, Leong MS. MF, Hallet M, Jankovic J, editors. Scientific and therapeutic aspects of botulinum toxin. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 207-16.
• Delgado MR. The use of botulinum toxin in juvenile cerebral palsy. In: Brin MF, Hallet M, Jankovic J, 25. Polo M. Botulinum toxin type A in the treatment of editors. Scientific and therapeutic aspects of botulinum toxin. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 217-22.
• Moore AP. Botulinum toxin type A in the treatment of spasticity. In: Brin MF, Hallet M, Jankovic J, editors. Scientific and therapeutic aspects of botulinum toxin. Philadelphia: Lippincott Williams 27. Katz H, Blumenfeld A. Can Botulinum toxin A and Wilkins; 2002. p. 223-32.
• Karp BI. The role of botulinum toxin type A in the management of occupational dystonia and writer’s cramp. In: Brin MF, Hallet M, Jankovic J, editors. Scientific and therapeutic aspects of botulinum toxin. 28. Hexsel D, Rutowitsch MS, de Castro LC, do Prado Philadelphia: Lippincott Williams and Wilkins; 2002. p. 251-8.
• Schwartz M, Freund B. Botulinum toxin A therapy for temporomandibular disorders. In: Brin MF, Hallet M, Jankovic J, editors. Scientific and therapeutic aspects of botulinum toxin. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 259.
• Gadhia K, Walmsley AD. Facial aesthetics: is botulinumtoxin treatment effective and safe? A systematic review of randomized controlled trials. Br Dent J 2009: 207: 1–9.
• Rubinstein A, Kostianovsky A. Cosmetic surgery for the malformation of the laugh: original technique. Prensa Med Argent 1973;60:952.
• Litton C, Fournier P. Simple surgical correction of the gummy smile. Plast Reconstr Surg 1979; 63: 372-3.
• Silva CO, Ribeiro-Junior NV, Campos TVS, Rodrigues JG, Tatakis DN. Excessive gingival display: treatment by a modified lip repositioning technique. J Clin Periodontol 2013; 40: 260–5. doi: 10.1111/ jcpe. 12046. gummy smile with surgical lip repositioning. J Cosmetic Dent 2007; 23: 100–8. J Orthod Dentofacial Orthop 2008: 133: 782–3.