Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Periodontology

Gummy smile is one of the common complaints of patients, since it can influence self-esteem and relationships. BTXA is a conservative, safe, fast and effective method in comparison to surgical techniques, however, its main drawback is its short-lasting effect.Aim: The aim of the study is to determine whether oral zinc supplement intake might affect the clinical efficacy and duration of BTX-A injection, in patients with excessive gingival display. Methodology: 26 participants with excessive gingival display were included in this parallel-group RCT, treated with BTXA with and without Zinc supplementation prior to treatment.Participants were assessed for EGD reduction and result stability at 2, 6, 12,18 and 24 weeks. Patient satisfaction questionnaires were filled at 2, 12 and 24 weeks. Additionally, pain and changes in smile type were also assessed. Results: It was revealed that after six,12,18 as well as 24 weeks; Group I (BTXA only) showed statistically significantly higher median gingival display than Group II (Zinc before BTXA). The median gingival display after 24 weeks showed statistically significantly lower median value (4mm) compared to base line measurement. Conclusions: Zinc supplementation improved the duration of the effect of BTX-A, and maintained long-term decreased amount of gingival display that was stable for over 24 weeks. As for the Patient reported outcomes PROs obtained by questionnaires, it was found that the participants appeared to have a high level of satisfaction

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