Table 2. The last 10 years (2014-2024) of clinical trials, case reports and observational studies on the aesthetic applications of Botox.

Reference	Study design	Subjects and condition	Objective	Parameters considered	Main outcomes	Conclusion
Yoelin SG et al. [18]	Randomized controlled trial	42 subjects who received EB-001 or placebo	Assessing the safety and effectiveness of EB-001, a new type of Botox, in individuals with glabellar frown lines.	Severity of glabellar frown lines; Adverse events, physical and examinations laboratory tests.	The incidence of adverse events was low, with mild to moderate headaches identified as the most common occurrence; No serious adverse events or ptosis were reported, and there were no clinically significant changes in other safety assessments;	EB-001 showed favorable safety, tolerability, and dose-dependent efficacy, with an 80 percent response rate at the highest dose. The maximum clinical effect of EB-001 was seen within 24 hours and lasted between 14 and 30 days.
Wanitphakdeedecha R et al. [19]	Randomized controlled trial	35 subjects diagnosed with bilateral symmetrical masseter hypertrophy through physical palpation	To compare the efficacy and safety of Onabotulinumtoxin A (ONA) and Botulinum toxin type A and NBT for masseter muscle reduction.	Standardized photographic; The mean volume of the masseter muscle; Patients' satisfaction levels and any side effects.	There was no statistically significant difference in the average volume between the two sides; The mean masseter volume at 3- and 6-month follow up visits reduced significantly on both ONA and NBT sides; No side effect reported on both sides after injection.	ONA and NBT offered similar efficacy and safety in reducing masseter size.
Demyati AK et al. [20]	Observational Study	255 patients	To examine the participants' viewpoints on the role of Botox in dentistry.		Participants' awareness of several Botox indications, including wrinkle reduction, treatment of muscle spasms, and management of a gummy smile; Participants identified infections, bruising, and eyelid drooping.	The use of Botox in dentistry has seen significant growth. While participants demonstrated a satisfactory understanding of Botox in aesthetic practices, they were less informed about its aesthetic applications.
Iozzo I et al. [21]	Observational Study	223 patients treated for facial wrinkles utilizing a novel approach known as the multipoint and multilevel injection technique (MMIT) for the administration of botulinum toxin A (BTA).	Patient satisfaction was evaluated using a standardized Facial Line Treatment Satisfaction Questionnaire (FTSQ), which comprises a series of predefined questions presented in a fixed and consistent sequence.		In individuals with youthful skin, facial wrinkles were completely eliminated, while in those with older skin, the wrinkles were significantly diminished, resulting in a natural appearance for both static and dynamic expressions; The application of botulinum toxin by MMIT allows for more precise control, resulting in softer and more natural-looking outcomes.	The multipoint and multilevel injection technique (MMIT) successfully minimizes facial wrinkles while ensuring a natural look, delivering personalized aesthetic results.
Pedron IG et al. [22]	Case Report	A patient who presented dentogingival discrepancy and gummy smile	Discussing a patient who exhibited a dentogingival discrepancy and a gummy smile.		The use of Botox offers a less invasive, quicker, safer, and more effective alternative. When applied to the appropriate muscles with the correct dosage, it yields harmonious and aesthetically pleasing results in relation to the desired smile.	This technique serves as a valuable complementary approach for enhancing the aesthetics of the smile and achieves improved outcomes when used alongside resective gingival surgery.
dos Santos AP et al. [23]	Case Report	A patient who presented with a headache accompanied by pain in the glabellar and frontal areas.	To present the case of a patient who experienced a headache along with pain in the glabellar and frontal regions.	Adverse events such as pain at the injection site, hematomas, infection, edema, eyelid ptosis, and asymmetry	The use of Botox for orofacial pain is linked to facial aesthetic improvements. These applications, performed by dental surgeons, can enhance patients' self-esteem and quality of life, alongside their anticipated therapeutic benefits.	Botox has emerged as an effective therapeutic and aesthetic option for various dental applications.
Mya N et al. [24]	Case report	A woman collapsed at a beauty salon shortly after receiving a Botox injection.			Despite resuscitation efforts in the hospital's emergency unit, she was unable to be revived and unfortunately passed away.	This case report emphasizes the rare occurrence of sudden death following a Botox injection. Researchers encourage individuals to be aware of the potential unforeseen risks associated with cosmetic procedures while seeking beauty enhancements.