TISSUE ENGINEERING AND ANTI-AGING - Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine - page 729

aesthetic zone, which focuses on microaesthetics (anything inside
theoralcavity).However,inthecaseofapatientwhohasaseverely
absorbed alveolar ridge, a prosthesis lacks a gum section, which
may result in insu cient lip support. 15 , 16 , 17 This means that a
patient with an implant-based prosthesis for the front teeth may
develop facial concavity and skin wrinkles as the patient ages. Den-
tistsprovidepatientswithwhattheyaremorecommonlyseeking—
a highly aesthetic appearance. There are other aspects of facial
aesthetics—the so-called “macroaesthetic” profile that focuses on
the overall facial appearance of the patient. Many patients are
hyperaware of rhytides, or wrinkles, in the perioral region, which
may detract from an overall pleasing appearance. A rhytide may
be divided into dynamic and static conditions. Dynamic wrinkles
occur during the contraction of muscles and are most prominent
in the forehead and eye region of the face. These wrinkles are best
treated by a paralyzing drug, such as botulinum toxin. Botulinum
toxin (Botox, Allergan, Inc., Irvine, Calif) is a deadly poison pro-
duced by the Clostridium botulinum bacterium. Clinical applications
include blepharospasm, strabismus, and hemipatial spasm. New
clinical uses in the fields of cosmetic dermatology include its use
for the management of hyperfunctional facial lines, most commonly
in the regions of the glabella, periorbital crow's feet, and forehead
lines.
Static wrinkles are present even when the face is relaxed. The
most prominent static wrinkles are in the inferior third of the face,
betweenthenoseandthechin.Thisregionisofprimaryimportance
to the dentistand willbeaddressed in this article.
Deep nasolabial folds, prominent “marionette” lines at the infe-
rior corners of the mouth, or a flat, attractive appearance is a key
factor in skin rejuvenation.
Our results indicate that a combination of dental implants and
gingival fibroblasts with HA injections may provide an acceptable
treatment for patients, especially those desiring better aesthetic
results.Ourinitialexperiencewiththeautologousgingivalfibroblast
injection process indicates that it is probably capable of producing
ongoing improvements in perioral lip wrinkles without the hyper-
sensitivity complications and harvesting challenges associated with
other treatments.