The aim of the proposal study is to answer the question of how to manage gummy smiles due to hypermobile upper lip with less invasive and low risk level procedure . This trial will help the practitioners and the patients in taking the convenient decision to correct the gumminess to restore lip-gingival-dental harmony and enhance smile asthetics.
In this randomized clinical trial , two groups will be included to compare the effectiveness of a treatment modality of botulinum toxin-A injection , in the first group , on gingival display during smiling ,patient satisfaction , lower face esthetics ( upper lip length , upper lip vermillion length , interlabial gap , nasolabial angle) and the postoperative side effects . the comparator group will receive treatment by modified lip repositioning surgery ,to compare the results of the intervention group that can possibly obtained without undergoing surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
22
adult patients with gummy smile due to hypermobile upper lip will receive Botulinum Toxin A Injection with a single injection1 cm lateral to the ala horizontally and 3 cm above the lip line vertically.
the surgical procedure will be done by removal of strip of epithelium by careful dissection and stabilizing the new mucosal margin to the gingiva to improve the gingival display in adult patients with gummy smile.
Patient satisfaction and postoperative side effects
it will be assessed using Questionnaire.
Time frame: at 4 weeks
Improvement of gingival display upon smiling
it will be assessed using Digital ruler on DSS software
Time frame: at 4,8 and 12 weeks
Lower face esthatics: a) upper lip length b) upper lip- vermillion length c) interlabial gap
it will be assessed using Digital ruler and angle measurement on DSS software
Time frame: at 4,8 and 12 weeks
Lower face esthatics: d)nasolabial angle
it will be assessed using Digital angle measurement on DSS software
Time frame: at 4,8 and 12 weeks
stability of gummy smile correction.
it will be assessed using Digital ruler on DSS software
Time frame: at the end of 24 weeks.
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