Effect of Botox Before Modified Lip Repositioning Repositioning Only in Relapse of the Excessive Gingival Display Within One Year

Inclusion Criteria: * Patients that is not satisfied with his smile having excessive gingival display * Adult Age ≥ 21 years. * Systemically and periodontally Healthy patients. * had gingival exposure greater than 3 mm when smiling * had a hyperactive upper lip with or without other causes of EGD (lip displacement ≥ 9 mm) before botox \& ≥ 3mm after. * Cooperative patients able and accept to come for follow up appointments. Exclusion Criteria: * • smoking * pregnancy or lactation * Systemic diseases; neuromuscular,neurological, or psychological disorders or consumption of controlled medication * Patients having medical condition or any drugs that could affect healing * Patients with systemic condition that can't undergo minor oral surgery * Patient allergic to Botox or multiple allergic conditions * have history of previous Botox injection * periodontal disease * excessive gingival display at rest * those who declined the informed consent or who did not consent to the risks described. * Those who have deviate smile