title: Botulinum Toxin for the Treatment of Excessive Gingival Display: A Systematic Review.
abstract: BACKGROUND
  To date, no standardized minimally invasive approach for the treatment of excessive gingival display exists.
  
  
  OBJECTIVE
  This systematic review aims to assess the evidence in the literature regarding the role of botulinum toxin injection in the management of gummy smile.
  
  
  METHODS
  All publications through December 2014 and pertaining to the subject were electronically searched in PubMed, Embase, Scopus, and Web of Science, and the bibliographies of retrieved articles were manually screened.
  
  
  RESULTS
  Out of 33 articles, 29 were discarded based on exclusion criteria. Although all 4 selected articles were in line with a role for botulinum toxin injection in the treatment of gummy smiles and the importance of targeting the levator labii superioris alaeque nasi muscle, studies differed in the type and the dose of toxin administered and the technique adopted.
  
  
  CONCLUSIONS
  Injection with botulinum toxin is a novel, safe, and cosmetically effective treatment for gummy smile when performed by experienced practitioners. However, further randomized controlled trials are warranted. LEVEL OF EVIDENCE 4: Therapeutic.
authors.affiliation: Dr Nasr is Assistant Professor and Dr Jabbour is a Resident, Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon. Dr Sidaoui is a Resident, Department of General Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: Marwan W
authors.initials: MW
authors.lastname: Nasr
authors.affiliation: Dr Nasr is Assistant Professor and Dr Jabbour is a Resident, Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon. Dr Sidaoui is a Resident, Department of General Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: Samer F
authors.initials: SF
authors.lastname: Jabbour
authors.affiliation: Dr Nasr is Assistant Professor and Dr Jabbour is a Resident, Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon. Dr Sidaoui is a Resident, Department of General Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Sidaoui
authors.affiliation: Dr Nasr is Assistant Professor and Dr Jabbour is a Resident, Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon. Dr Sidaoui is a Resident, Department of General Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: Roger N
authors.initials: RN
authors.lastname: Haber
authors.affiliation: Dr Nasr is Assistant Professor and Dr Jabbour is a Resident, Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon. Dr Sidaoui is a Resident, Department of General Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: Elio G
authors.initials: EG
authors.lastname: Kechichian
mesh_terms: D001905:Botulinum Toxins / Q000008:administration & dosage*; D005881:Gingiva / Q000033:anatomy & histology* / Q000187:drug effects*; D006801:Humans; D009498:Neurotoxins / Q000008:administration & dosage*
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins