{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:21:01Z","timestamp":1791876061570,"version":"4.3.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":95,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The perioral region plays a crucial role in facial aesthetics and is susceptible to age-related changes, such as wrinkles and fine lines due to its dynamic nature. Type I collagen is crucial in providing structural integrity and resilience to the skin. Calcium hydroxylapatite (CaHA-CMC) is a widely used dermal filler whose particles stimulate fibroblastic responses within the skin. When diluted, CaHA-CMC has emerged as a useful treatment for collagen stimulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of the study is to evaluate the efficacy and safety of hyperdilute CaHA-CMC at a 1:3 ratio, specifically administered in the perioral area, to assess its impact on deep rhytids and overall skin quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Females aged 40 to 70 years with moderate-to-severe wrinkles in the perioral region based on a validated wrinkle scale were injected with hyperdilute CaHA-CMC throughout the perioral region at 2 separate injection intervals (Weeks 1 and 8). This was followed by an injection of hyaluronic acid (CPM-HA22.5) into the perioral region at Week 16. The primary endpoint was a \u22651-point improvement from baseline on the wrinkle grading scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve female participants were treated. Investigator and patient ratings based on the 5-point Merz perioral\/lip wrinkle grading scale showed at least 1 grade improvement in 83% of the patients with a P-value of .0156. A majority of both investigators and patients rated their lip wrinkles as improved in appearance compared with their baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hyperdilute CaHa-CMC at a 1:3 dilution may be a safe and effective treatment for improving the depth and overall appearance of perioral rhytids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asjof\/ojae021","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T09:29:32Z","timestamp":1712309372000},"source":"Crossref","is-referenced-by-count":7,"title":["Hyperdilute Calcium Hydroxylapatite for the Treatment of Perioral Rhytids: A Pilot 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