露龈笑和肉毒杆菌毒素:一种基于牙龈暴露面积的新方法
Gummy smile and botulinum toxin
【 文献重点摘要 】
Background
Gummy smile (GS) is an aesthetic disorder for some patients, which can be corrected by injection of botulinum toxin.
Objective
We sought to classify GS according to the area of gingival exposure and the respective muscles involved in order to perfect the botulinum toxin injection technique for each patient.
Methods
Sixteen patients with GS were evaluated before receiving botulinum toxin injections. Based on the area of excessive gum displayed and identification of the muscles involved, 4 different types of GS were identified: anterior, posterior, mixed, and asymmetric. AbobotulinumtoxinA (Dysport, Ipsen Biopharm Limited, Wrexham, UK) was injected using a different injection technique for each type of GS, based on the main muscles involved. With the aid of two computer programs, the area of gum exposed was measured before and after the application of abobotulinumtoxinA, to evaluate the level of improvement.
Results
There was a decrease in the degree of gum display in all patients. The general average improvement achieved was 75.09%. Two patients showed slight adverse effects that were easily corrected with additional doses of abobotulinumtoxinA.
Limitations
For this study, there was no sample size calculation and no statistical analysis of the cases.
Conclusion
The authors conclude that it is important to identify the type of GS and therefore the main muscles involved, so that the correct injection technique can be used. AbobotulinumtoxinA was shown to be effective and safe for use in all types of GS in the present sample.
Keywords
abobotulinumtoxinA; asymmetric smile; botulinum toxin; Dysport; gingival exposure; gummy smile
背景
露龈笑(GS)是一些患者的一种审美障碍,可以通过注射肉毒毒素来纠正。
目的
根据牙龈暴露面积和受累肌肉对牙周炎进行分类,以完善每个患者的肉毒毒素注射技术。
方法
对16例GS患者在接受肉毒毒素注射前进行评估。根据所显示的过量牙龈面积和受累肌肉的识别,共识别出4种不同类型的GS:前型、后型、混合型和不对称型。基于所涉及的主要肌肉,对每种类型的GS使用不同的注射技术注射AbobotulinumtoxinA (Dysport,Ipsen Biopamm Limited,UK,Wrexham)。借助两个计算机程序,测量使用abobotulinumtoxinA 前后牙龈暴露面积,评价改善程度。
结果
所有患者的牙龈显影程度均有不同程度的降低。总平均改善率为75.09%。两名患者表现出轻微的不良反应,可以通过额外剂量的abobotulinumtoxinA 很容易纠正。
局限性
本研究没有计算样本量,也没有对病例进行统计分析。
结论
作者认为,确定GS的类型以及涉及的主要肌肉是很重要的,这样才能使用正确的注射技术。在本样本中,AbobotulinumtoxinA 被证明用于所有类型的GS是有效和安全的。
关键词
abobotulinumtoxinA;不对称微笑;肉毒毒素;Dysport;牙龈暴露;露龈笑