الفهرس | Only 14 pages are availabe for public view |
Abstract Excessive Gingival Display (EGD) is a common feature where many patients find it displeasing and hence seek treatment to enhance it. Lip repositioning surgery was introduced as a solution for elimination of EGD caused by hyperactive lip. However, relapse was shown to occur despite it was not adequately reported in literature. Moreover, all published literature was case studies and lacked long term follow-up for the cases. The aim of our research is to assess the relapse resulting from the lip repositioning surgery and the adjunctive use of BTX-A injections with the surgery, provided with a long term follow-up. Twenty patients were allocated and divided randomly into two groups. The study group had BTX-A injections followed by lip repositioning surgery while the control group underwent the surgery alone. All patients were planned to undergo standardized photographic assessment pre-operative, one, three, six and nine months post-operative. Nine measurements had been performed for the patients including the amount of gingival display and consequent soft tissue changes. The results showed significant decrease in amount of gingival display in both groups in one and three month post-op. Yet the amount of gingival display started to show relapse in the six month post-op follow-up in the control group, in comparison to the study group which showed relapse in the nine month post-op follow-up. Other soft tissue measurements showed significant changes in the control group as outer lip length during smiling and vermillion Summary and Conclusion 91 height at both rest and smiling. On the other hand, most of those measurements changes were not significant in the study group. Conclusion: Excessive Gingival Display (EGD) etiology should be well diagnosed to decide which treatment option is most suitable for the patient. Hyperactive lip as a cause for EGD has a controversial management, and more studies are needed to detect which line of the treatment is the most effective. Lip repositioning surgery is a simple and less aggressive procedure to be done in those cases. However, long term results showed near complete relapse with the procedure. Adjunctive use of Botulinum toxin injections with the surgery did not add benefit regarding the amount of gingival display after surgery. However, it showed to decrease the soft tissue changes caused by the surgery. Moreover, it delayed the relapse to be in the nine months post-op instead of six months post-op |