Main Instructor 鄧雅音
Department / Institution Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Linkou branch, Taiwan
Classification Case report
Harmonious smile is one of the main concerns for patients seeking orthodontic treatment. Patients with excessive gingival display usually feel embarrassed to smile. Treatment of gummy smile should be planned according to the etiology and cost/benefit evaluation. The aim of the presentation is to describe the orthodontic treatment of an adult patient with skeletal Class II and gummy smile.
A 23-year-old female patient presented with the chief complaint of gummy smile and protrusive teeth. She was diagnosed as skeletal Class II malocclusion and vertical maxillary excess. She had Class II molar relation, deep overbite, large overjet, as well as excessive curve of Spee. It also showed shifted dental midline, severe crowding on the upper arch and mild crowding on the lower arch. According to the etiology and patient's expectation, camouflage orthodontic treatment was the alternative. Extraction of two upper premolars to relieve crowding and reduce protrusion was provided. In addition, intrusion of upper anterior and posterior teeth was performed by TADs. Through the proper utilization of TADs, excessive gingival display was resolved and good incisor torque was established. A pleasing smile, proper overbite and overjet were achieved without evidence of severe root resorption after a three-year treatment.
Discussion and summary:
Accurate diagnosis and proper treatment strategy are the prerequisites for solving gummy smile. In selected cases, reduced excessive gingival display can be accomplished by orthodontic treatment without other surgical procedures. The 4-mm intrusion of upper incisors could be expected through utilization of two anterior TADs.
Orthodontic Treatment of Gummy Smile in A Skeletal Class II Adult Patient