Non-Surgical Approaches for Management of Gummy Smile

Abstract

1. Purpose The management of gummy smiles, characterized by an excessive gingival display of more than 2-3 mm, has become increasingly relevant due to the growing aesthetic concerns among patients. This study aims to evaluate the efficacy and durability of non-surgical approaches, including Botulinum toxin type A (BTX-A), hyaluronic acid (HA), and micro-autologous fat transplantation (MAFT), for treating gummy smiles. The focus is on assessing these methods' effectiveness in reducing gingival display and improving patient satisfaction. 2. Methods A narrative literature review was conducted, sourcing studies from PubMed, Embase, Cochrane, Google Scholar, Science Direct, and Open Gray. The inclusion criteria focused on adult patients with gummy smiles treated exclusively through non-surgical methods, with a follow-up period of at least six months. Quality was assessed using the CASP and Cochrane risk-of-bias tools. 3. Results The review included eight studies. Five utilized BTX-A, showing significant, though temporary, reductions in gingival display and high patient satisfaction rates. One study on HA fillers demonstrated significant improvement in gummy smiles, with effects lasting up to eight months. MAFT provided the longest-term results up to 12 months, although it was limited by a small sample size. Overall, most studies reported high levels of patient satisfaction, and a significant reduction in the excessive gingival display indicating the effectiveness of these non-surgical treatments for gummy smiles. 4. Conclusions Non-surgical treatments for gummy smiles, including BTX-A, HA, and MAFT, have shown promising results in reducing gingival display and enhancing patient satisfaction. Despite there are some methodological limitations, these treatments provide feasible alternatives to surgical procedures. However, further research with larger sample sizes and longer follow-up periods is recommended.