3/25/2023 0 Comments Smile orthodonticsA modified TPA was fabricated with 1 mm stainless steel wire and a central acrylic pad such that it stayed approximately 5 mm from palatal mucosa. Four miniscrews (diameter 1.5 mm and length 8 mm) were placed in the maxillary buccal region and two miniscrews in the lower posterior region buccally under local infiltration anesthesia. After Six months, alignment up to the 0.019 X 0.025 inches stainless steel arch wires was achieved. Conventional alignment and leveling were performed in the upper and lower arches. A preadjusted fixed appliance 0.022 × 0.028” slot (MBT prescription) was bonded to the maxillary and mandibular arches. Treatment progressĪll upper and lower first premolars along with all upper and lower third molars were extracted. Two miniscrews buccally in the lower arch were used to hold the lower arch. Four maxillary buccal miniscrews and a modified TPA were then used for the intrusion of the entire maxillary arch. Both the alternatives were explained to the patient, who chose the more conservative second option. The following two treatment options were given to the patient:Ĭonventional orthodontic treatment with extraction of upper and lower first premolars and third molars combined with orthognathic surgery (Le Fort 1 maxillary impaction and augmentation genioplasty)Įxtraction of all upper and lower first premolars along with all upper and lower third molars followed by orthodontic intrusion of complete maxillary dentition using absolute anchorage system.Ĭonsidering the severity of the case, orthognathic surgery was suggested as the first option, toward which the patient showed reluctance. Reducing the vertical dimension to improve facial balance This included the following:Ĭorrecting anterior proclination and creating a normal overbite and overjet relationship Our treatment objectives included improving the patient’s smile esthetics and facial profile along with a harmonious occlusion. U1-NF – Upper anterior dentoalveolar height L1-MP – Lower anterior dentoalveolar height U6-NF – Upper posterior dentoalveolar height L6-MP – Lower posterior dentoalveolar height Treatment objectives She also had “Gull Wing” lip deformity with short upper lip, lip trap, and mentalis strain on closing. Case ReportĪ 24-year-old female patient presented with skeletal Class II malocclusion and gummy smile along with protrusion. This case report describes orthodontic treatment of a 24-year-old female patient with skeletal Class II malocclusion, gummy smile, proclination, and hyperdivergent profile in whom gummy smile correction was achieved by intrusion of the entire maxillary dentition using four miniscrews buccally in the maxillary arch and a modified TPA. ![]() However, alternative method using miniscrews is now frequently used in cases where going under the knife is an issue. In such situations, often surgical therapy like a Le Fort impaction is needed to improve esthetics. Gummy smile along with a hyperdivergent profile is often characterized by excessive maxillary posterior dentoalveolar height along with excessive anterior dentoalveolar height. ![]() Gummy smile poses an esthetic problem and requires proper diagnosis and treatment planning. ![]() ![]() used mini-implant with segmented wires to achieve intrusion. treated vertical maxillary excess by single palatal implant and modified transpalatal arch (TPA). In recent times, mini-implants have been used for multiple purposes – for correction of gummy smile with increased anterior facial height by full maxillary arch intrusion deep bite correction by intrusion of incisors and open bite correction by molar intrusion. Each time you visit our office, our entire team works hard to ensure that your time with us is as positive, comfortable, and relaxing as possible. Whether you are interested in traditional braces, metal braces, oral appliances, or other orthodontic and dental care treatment options, we are committed to providing you with the high-quality, gentle care you deserve. We have provided orthodontics in Carlsbad, California, and the surrounding areas of San Marcos, Vista, Oceanside, Encinitas, and Solana Beach, California, for several years.Our orthodontist and friendly, welcoming team use digital X-rays and quality materials to align the teeth of both kids and adults so they can have an even bite, healthy mouth, and beautiful smile. Our office maintains an easygoing, laidback atmosphere that will help you and your family relax while receiving professional orthodontic care from Dr. Welcome to Full Smile Orthodontics, where beautiful, healthy smiles are our specialty.
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