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Second, CSMC abnormalities arise through TNF--induced apoptosis, PI3K/Akt inhibition, TGF-1-driven phenotypic transformation, ROCK-mediated hypercontractility, and extracellular matrix deposition (160)

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It is commonly used for expression lines, gummy smile concerns, and some cases of jaw muscle tension

This document is a supplemented version of the guidelines first published in this form in 2020 [6, 7]