Manar M Abdel Zaher , Noha Ahmed Mansour And Mohammed Abdel Moneim Tawfic,

ABSTRACT
Background: Excessive Gingival Display (EGD) Commonly Referred To As A �gummy Smile� Can Be A Source Of Embarrassment For Some Patients.

Purpose: This Study Was Conducted To Evaluate Clinically, The Effect Of Lip Repositioning Surgery (LRS) Versus Botox Injection For Patients With Gummy Smiles (GS) As A Two Different Treatment Methods.

Materials and Methods: Twenty Healthy Female Patients With Age Range Of 18-35 Years Old And GD Range Of 3.5-9 Mm Were Selected For This Study. Patients Were Divided Into Two Equal Groups As Follow: Group (1): In Which Patients Were Treated Surgically By Lip Repositioning Technique, Group (2): In Which Patients Were Treated By Intramuscular Injection Of Botulinum Toxin Type A (BTX-A) At Pre-selected Sites. The Amount Of Gingival Display Was Evaluated At The Following Intervals, 2 Weeks, 1 Month, 3 Months, 6 Months, 9 Months And One Year.

Results: The Results Of This Study Showed Noticeable Reduction In The Amount Of Gingival Display For All Patients In Both Groups With No Significant Difference Between Them After 2 Weeks, 1 Month And Three Months Of Examination. After 6 Months Significant Difference Between Them Was Recorded As In Group (2) The Effect Of BTX-A Was Completely Disappeared While Patients In Group (1) Still Having Their EGD Reduced. Nine Months Later, The Effect Of LRS Also Had Been Disappeared And The Amount Of EGD Returned To The Baseline Value.

Conclusions: Both LRS And BTX-A Injection Are Effective Treatment Methods For Patients Suffering From EGD. The Results After Applying Both Modalities Are Transient, However LRS Has More Prolonged Results Than BTX-A.