Use of botulinum toxin type A for the treatment of gummy smile. A literature review
DOI:
https://doi.org/10.24265/zyqmk772Keywords:
Botulinum Toxins, Type A, Smiling, GingivaAbstract
Gummy smile (GS) is characterized by excessive gingival display during smiling, which affects facial aesthetics. It has a multifactorial etiology, involving muscular, periodontal, or skeletal causes; therefore, an accurate diagnosis is essential for treatment selection. Botulinum toxin type A (BoNT-A) is used as a minimally invasive option in cases of muscular origin. This study aimed to analyze the available scientific evidence regarding its clinical efficacy, patient selection criteria, application techniques, and therapeutic limitations. A literature review of scientific articles published in biomedical databases - including PubMed, Scopus, ScienceDirect, and Google Scholar - between January 2014 and December 2025 was conducted. The literature search yielded a total of 1,427 articles, from which 30 studies met the selection criteria and were included in this manuscript. The reviewed publications indicate that BoNT-A achieves a significant reduction in gingival display in mild to moderate cases, resulting in high levels of aesthetic satisfaction and a low incidence of complications when applied under appropriate anatomical criteria. However, its primary limitation is the transient nature of its effects, requiring periodic reapplications to maintain the outcomes. In conclusion, BoNT-A constitutes a safe and effective therapeutic alternative within the interdisciplinary management of GS, provided that its indication is based on a precise diagnosis and proper individualized planning.
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