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REESTABLISHMENT OF ESTHETIC APPEARANCE BY USING ‘BOTULINUM TOXIN A’ ON A GUMMY SMILE CASE
PURPOSE: ‘Botulinum toxin A’ (Botox) was shown to be effective in several medical conditions both therapeutically and cosmetically. There was a rising trend in the use of botox to treat gummy smile recently. The purpose of this case report is to reestablish esthetic appearance with botox injections and laminate veneer applications on a gummy smile case, and also to evaluate the efficiency and longevity of botox. CASE REPORT: A 33 years old female patient attended to the dental clinic reporting dissatisfaction with the appearance of her smile which exhibited gummy smile and unattractive teeth form. Her gummy smile was recorded due to hyperactive lip elevator muscles. Digital smile design (DSD) was used to see the effect of crown lengthening without botox injections. As a result, the appearance was not satisfying, so botox injection was applied at Yonsei point (BOTOX, Allergan Inc., Irvine, CA). Excessive gingival exposure was decreased 3 mm twenty days after injection. Minimal invasive preparations of the upper 9 teeth from premolar to premolar were done, teeth were restored with lithium disilicate laminate veneers (IPS e.max Press, Ivoclar Vivadent, Schaan, Lichtenstein). RESULTS: It was seen that botox is a minimally invasive and effective method that satisfies the patient. DSD helps about pre-visualization of the appearance and treatment plan can be done properly according to patient. CONCLUSION: There are several treatment options for gummy smile such as orthognathic surgery, orthodontic treatment, gingivoplasty or alveoloplasty and also botox. Botox is more widespread in the last years thanks to its properties of less invasive, faster, safer and more effective than surgical techniques. Before planning the treatment, botox should be evaluated instead of surgical techniques and the decision should be made according to the patients’ situation. The information about the temporary effect of botox should be given to the patient.