Authors : Anil Miglani, Reena R kumar
DOI : 10.18231/j.jco.2019.016
Volume : 3
Issue : 2
Year : 2019
Page No : 33-38
Background: Malocclusions with gummy smile and vertical maxillary excess mainly occurs by overgrowth of the maxillary anterior dentoalveolar heights, but it is difficult to intrude anterior segment with conventional orthodontic mechanics. Surgical treatment i.e. anterior maxillary osteotomy is the treatment of choice in such cases. However, if the patients are not willing to undergo surgical intervention, an alternative method must be considered to treat the gummy smile.
Aim: To describe the non-surgical treatment of skeletal malocclusion with vertical maxillary excess and gummy smile.
Method: In this case series, we treated malocclusions with severe gummy smile and vertical maxillary excess using mini-plates instead of mini-implant, so that:-
1) Simultaneous molar distalization, premolar retraction & anterior retraction with intrusion could be achieved with segmental mechanics.
2) Variable force vectors depending on amount of intrusion and retraction required in cases could be applied by varying line of action of force.
3) Mini-plates are more stable at higher forces.
Results: In all the cases the treatment resulted in marked improvement in the facial profile and correction of gummy smile. Ideal overjet and overbite was achieved. The cases were finished with Class I Molar and canine relation. Upper incisors were intruded & retracted remarkably avoiding orthognathic surgical intervention to correct gummy smile.
Conclusion: Mini-plate is a viable treatment option for correcting dentoalveolar malocclusion with vertical maxillary excess and severe gummy smile.
Keywords: Mini-plates, Anterior Maxillary Osteotomy, Gummy smile, Vertical Maxillary Excess