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Background: The demand for beauty is increasing in society as everyone is looking for cosmetic improvement, including gummy smile correction.
Object: 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
Method: An uncontrolled longitudinal study was implemented at the Faculty of Odonto-Stomatology (FOS) of the University of Medicine and Pharmacy at Ho Chi Minh City (UMPH), Viet Nam, from August 2020 to May 2021. Twenty patients (19 females and one male) at a mean age of 24 years old who came for gummy smile chief complaint were included in the study. Subjects were operated to lengthen the clinical crown following an additional botulinum toxin A injection two months post-surgery. All the participants answered the smile esthetic satisfactory questions and were photographed at the time before treatment (T0), two months after clinical crown lengthening surgery (T1), two weeks (T2), and two months (T3) follow-up visits after BTX-A injection. The gingival exposure (GE) and clinical crown length (CCL) were measured at each time point for analysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subjects with gummy smile | Experimental | The study procedure consisted of recruitment, pre&post-operative photography, gingivoplasty, BTX-A injection, recall visits, and data collecting. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clinical crown lengthening surgery | Procedure |
After local anesthesia, the doctor administered slowly 2,5 U of diluted BTX-A at each point until white cellulite appeared. Patients were recalled two weeks (T2), and two months (T3) after injection. |
| Measure | Description | Time Frame |
|---|---|---|
| Gingival exposure | The outcome is measured in millimeters based on photos of subjects included | At the time before treatment (T0) |
| Gingival exposure | The outcome is measured in millimeters based on photos of subjects included | Two months after clinical crown lengthening surgery (T1) |
| Gingival exposure | The outcome is measured in millimeters based on photos of subjects included | Two weeks after Botulinum toxin A injection (T2) |
| Gingival exposure | The outcome is measured in millimeters based on photos of subjects included | Two months after Botulinum toxin A injection (T2) |
| Clinical crown length | The clinical crown length is measured in millimeters using digital caliper and periodontal probe | At the time before treatment (T0) |
| Clinical crown length | The clinical crown length is measured in millimeters using digital caliper and periodontal probe | Two months after clinical crown lengthening surgery (T1) |
| Clinical crown length | The clinical crown length is measured in millimeters using digital caliper and periodontal probe | Two weeks after Botulinum toxin A injection (T2) |
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Inclusion Criteria:
Gummy smile because of 2 combined etiologies:
Exclusion Criteria:
Pregnant or breastfeeding patients
Gummy smiles due to:
Systematic diseases that can affect the result of surgical treatment (such as diabetes, heart disease taking blood anticoagulant medicament, blood diseases, immunodeficiency disease etc.)
Allergy to BTX-A or albumin
History of taking BTX-A injection in the head-neck area formerly
Patient with any contraindication of surgery
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Odontostomatology - University of Medicine and Pharmacy at Ho Chi Minh City | Ho Chi Minh City | 749000 | Vietnam |
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| ID | Term |
|---|---|
| D019274 | Botulinum Toxins, Type A |
| ID | Term |
|---|---|
| D001905 | Botulinum Toxins |
| D008666 | Metalloendopeptidases |
| D010450 | Endopeptidases |
| D010447 | Peptide Hydrolases |
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Participants were recruited from patients who came for chief complaint of excess gingival display at the Dental Clinic of the Faculty of Odonto-stomatology, University of medicine and Pharmacy at Ho Chi Minh City. The study population included patients aged from eighteen years with an average length of excessive gingival display ≥ of 4 mm when maximum smiling (counted eight teeth, from the 14 to the 24 teeth) and the height of keratinized gingiva ≥ 3 mm.
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|
|
| Clinical crown length |
The clinical crown length is measured in millimeters using digital caliper and periodontal probe |
| Two months after Botulinum toxin A injection (T2) |
| D006867 |
| Hydrolases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
| D045726 | Metalloproteases |
| D001426 | Bacterial Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D001427 | Bacterial Toxins |
| D014118 | Toxins, Biological |
| D001685 | Biological Factors |