Treatment of Excessive Gingival Display by Using Botulinum Toxin-A Targeting Yonsei Points and Zygomatic Major Muscles

The aim of this clinical report is to present satisfying and unsatisfying treatment results of a patient with excessive gingival display (EGD) treated via botulinum toxin injections in different time points. A 22-year-old male patient referred to the Department of Periodontology with a complaint of EGD. The patient opted the treatment with botulinum toxin-A injections. During the first treatment, injections at Yonsei points were performed. After the first EGD treatment, the patient did not satisfy with his smile. The closure of gingival display was not sufficient, especially in posteriors. However, he did not demand for reinjection. Six months after the first treatment, he was advised to have 2 injection points per side including zygomatic major muscles as well as Yonsei points. Two weeks after the second treatment, the patient totally satisfied with his new smile. Yonsei point is a safe and repeatable injection point for the practitioners. However, the authors suggested injections targeting zygomatic major muscles as well as Yonsei point injections to treat the patients with mixed EGD.