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Treating a severe iatrogenic gingival exposure and lip incompetence - a challenge worthwhile
Adith Venugopal1, Paolo Manzano2, Jassin Arnold3
1Department of orthodontics, University of Puthisastra, Phnom Penh, Cambodia.
International Orthodontics
|September 21, 2020
Summary
This case study presents a non-surgical orthodontic retreatment for a severe malocclusion, correcting a dual occlusal plane and gummy smile. Miniscrew anchorage enabled anterior intrusion and arch retraction, offering a surgical alternative.
Area of Science:
- Orthodontics
- Dental Biomechanics
Background:
- Previous orthodontic treatment resulted in iatrogenic effects, including a dual occlusal plane and anterior dental extrusion.
- This led to an exaggerated severe dento-skeletal malocclusion with a vertical growth pattern, gummy smile, increased overjet, deep bite, and incompetent lips.
Observation:
- A young adult patient presented with significant malocclusion and aesthetic concerns following prior orthodontic interventions.
- The patient exhibited a high smile line and a convex facial profile.
Findings:
- Anterior maxillary segment intrusion using anterior miniscrew anchorage corrected the extrusion and deep bite.
- Posterior retraction of the maxillary arch with IZC screws addressed the overall malocclusion.
- The combined approach effectively altered the smile line and facial profile, mimicking surgical anterior impaction.
Implications:
- This orthodontic retreatment offers a viable, non-surgical alternative to orthognathic surgery for correcting complex malocclusions.
- Combining intrusion mechanics with gingivectomy provides significant aesthetic improvements, avoiding surgical risks and costs.
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