Treating a severe iatrogenic gingival exposure and lip incompetence - a challenge worthwhile
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Updated: Dec 8, 2025

Induction of Periodontitis via a Combination of Ligature and Lipopolysaccharide Injection in a Rat Model
Published on: February 17, 2023
Adith Venugopal1, Paolo Manzano2, Jassin Arnold3
1Department of orthodontics, University of Puthisastra, Phnom Penh, Cambodia.
Abstract:
This case reports the retreatment of a young adult who had a previous orthodontic history of inappropriate biomechanical strategies leading to iatrogenic effects with the formation of a dual occlusal plane causing anterior dental extrusion. As a result, an already severe dento-skeletal malocclusion with a vertical growth pattern, severe gummy smile, increased overjet and a very deep bite along with procumbent and incompetent lips became exaggerated. The high smile line and heavy convex profile were changed to an average smile line and a straight profile by intruding the anterior maxillary segment with anterior miniscrew anchorage and retracting the whole maxillary arch using IZC screws posteriorly. The treatment effect was similar to an anterior surgical impaction, thereby offering patients a viable alternative. Combining intrusion and gingivectomy produced an aesthetically pleasing smile and profile without the cost, morbidity, and potential complications of orthognathic surgery.
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