A 27-year-old female patient complaining of excessively displaying the gingival region on smiling came to consultation with the aim of improving the aesthetics of her gingival smile.
The patient reports that she is not willing to perform an invasive procedure to correct her oral situation.
At the time of clinical evaluation, it was observed that it presented 4 mm of gingival exposure.
1.
The etiology of the gingival smile was evaluated, reaching the diagnosis that its gingival smile was due to hyperactivity of the upper lip elevator muscle.
Among the options to solve the case presented to the patient (including advantages and limitations of each), we chose the treatment with BTX-A, in order to reduce the upper lip contraction force.
To locate the application point, the "Yonsei Point"2 technique, described in Figure 2, was used.
1.
The 100 units (U) commercial Allergan household toxicant was used as the medication of choice.
Dilution of the product was performed as described in the instructions for use.
BTX-A was diluted with 2 ml of sterile unpreserved 0.9% saline to produce 5 U per 0.1 ml.
Located 2.5 U in the upper lip elevated muscle, bilaterally.
The patient was evaluated 2 weeks after application.
Gingival exposure decreased markedly from the first evaluation and the patient reported being satisfied with the treatment, a result that was maintained without the need for new medication applications for 6 months.
