Introduction: A gummy smile (GS) affects the esthetic and the psychological status as it usually decreases the self-confidence leading to hidden or controlling the smile. A smile with more than 2 mm exposed gingiva is called gummy smile. It may be due to one or more of the following etiologies; altered passive eruption of teeth, dentoalveolar extrusion, vertical maxillary excess, and short or hyperactive lip muscles. The treatment of gummy smile should be planned according to its cause/causes. The purpose of this case report was to highlight the ability of combined treatment of gingivectomy and Botox injection technique in managing a severe gummy smile. Also, techniques, advantages, disadvantages, indication and contraindications of Botulinum toxin (BT) are discussed at the literacy. Presentation of the case: A 24 year old female patient with a severe gummy smile was refereed to the periodontal clinics of our institution. Clinical examination revealed that she has a GS of an 11-12 mm gingival exposed area that was indicated for orthognathic surgery. The GS was treated by a gingivectomy surgery to increase the clinical crowns of upper anterior teeth and the use of Botox injections. The treatment showed remarkable and satisfactory results instead of doing extensive surgery. Discussion and conclusion: It is important to assess the patients' esthetic expectations and show the possible therapeutic solutions that fit him. We revealed that BT is considered as one of the minimally invasive, quick and affordable modalities that can replace extensive surgical procedures for corrections of sever GS. Highlights:

BACKGROUND: The development of periodontal diseases depends on the presence of causative microorganisms, host immunity and risk factors. Although variability present among the types of periodontal diseases, all are represented to a shared interaction between host and bacteria. ABO blood groups are the most investigated erythrocyte antigen system. However, limited investigations have been conducted to explore the alliance between ABO blood groups and periodontal diseases. AIM: Our purpose was to explore any possible association between the severity of chronic periodontitis with ABO blood groups and Rh factor. METHODS: A cross-sectional study was carried out on 205 patients out of 1126 generalised chronic periodontitis patients (GCP) who were referred to Al-Farabi Colleges, Riyadh, Saudi Arabia. They were categorized into; group I (mild), group II (moderate) and group III (sever). RESULTS: The patients with blood group O were at a greater risk to develop GCP irrespective of its severity, followed by those with blood group A, B, and AB. The dispensation of the Rh factor in all groups exhibited a significantly greater distribution of Rh positive. CONCLUSION: Genetic factors such as ABO blood group antigens may act as a risk influencer that affects the progression and severity of the chronic periodontitis.

A gingival depigmentation is a periodontal plastic procedure that is performed in order to remove melanocytic pigmentation. A variety of different modalities have been proposed for removing hyperpigmentation involving surgical scraping, gingival autograft, cryotherapy, electrosurgery, and lasers. However, the microneedling technique is a nonsurgical procedure that creates microholes to facilitate the penetration of topical medications across the connective tissues. Case Description . A healthy female patient aged 25 years with a pigmented gingiva seeking gingival depigmentation. On examination, a dark brown ribbon of hyperpigmentation was observed within the mandibular attached gingiva. The case was diagnosed as physiological moderate gingival pigmentation (pigmentation index score = 3). The patient was interested in achieving aesthetic results with minimally invasive, nonexpensive procedures. Based on the patient’s concerns, the microneedling technique using vitamin C was suggested and consented. We used a dermapen device to microneedle the gingiva until bleeding pinpoints were observed; then, topical ascorbic acid was applied. After 3 days, our outcomes revealed an excellent aesthetic pink gingival appearance. Conclusions and Practical Implications . Compared to other minimally invasive techniques, our technique is less expensive and more risk‐free. Our novel technique of using dermapen and topical ascorbic acid has shown promising results to our case which gives new perspectives for its application in gingival depigmentation.

BACKGROUND: Minor recurrent aphthous stomatitis (MiRAS) is one of the most common, recurrent, and painful mucosal pathological condition. It is characterised by round or shallow oval ulcers, less than 10 mm in diameter, surrounded by a thin erythematous halo. It involves non-keratinized mucosa such as the labial and buccal mucosa, the ventral surface or borders of the tongue and the floor of the mouth, but it is uncommon to occur on the keratinised mucosa. It heals spontaneously within 10-14 days without scarring. There is no curative remedy to prevent its recurrence; also, available modalities only reduce the symptoms and severity of the lesion. AIM: Since these lesions may be extremely painful, we decided to estimate the pain-relieving and healing properties of low energy level laser therapy using diode laser 660 nm on MiRAS. MATERIAL AND METHODS: Twenty healthy patients suffering from minor aphthous ulcers were randomly selected from the Out-Patient Clinic of Oral Medicine Department, Faculty of Dentistry, Alexandria University. They were equally divided into two groups, study group who received 660 nm diode laser irradiation while the control group received placebo (sodium bicarbonate rinse). The visual analogue scale, size reduction, effectiveness indices and functional disorders were compared between the groups. RESULTS: Both groups presented a statistically significant difference from baseline to follow up periods. But, diode laser 660 nm treatment showed more remarkable improvements in reduction of healing time, pain and lesion size. CONCLUSION: We concluded that diode laser 660 nm should be further considered as an effective alternative therapeutic regimen to patients who suffer from recurrent aphthous stomatitis.