Segmental intrusion and retraction with tads for the correction of gummy smile -A case report

Authors : Hariprasad A, Navedha , Shaji A P, Nadeer T, Mohamed Rijash

DOI : 10.18231/j.ijohd.2020.033

Volume : 6

Issue : 2

Year : 2020

Page No : 150-155

The intrusion of the maxillary anteriors with Temporary Anchorage Devices (TADs) is one of the most
common and effective treatment methods for the correction of gummy smile, but the main disadvantage of
this method is the extrusion of posterior teeth, especially when used in conjunction with a continuous
arch wire leading to an increase in the lower anterior facial height. The objective of this case report
is to demonstrate the true intrusion of the maxillary anterior segment without causing extrusion of the
posterior segment using a segmented arch wire rather than the routine continuous arch wire with the
assistance of TADs in a patient diagnosed with a 5 mm gummy smile. After the initial leveling and
alignment, a 0.019×0.025 stainless steel posted arch wire was sectioned distal to the canines. The TADs
were positioned bilaterally mesial to upper first molars and an intrusive force of 250gm was applied per
side using elastomeric chains attached to the miniscrews. At the end of the treatment, complete correction
of the gummy smile was achieved by the intrusion of maxillary anteriors without any significant extrusion
of the posteriors. The TAD assisted segmented arch wire for intrusion and retraction of maxillary anteriors
is an excellent method for the successful correction of the gummy smile rather than using regular continous
arch wire as we can avoid the unwanted extrusion of posteriors.

Keywords: Gummysmile, TADS, Segmental mechanics, Intrusion, Gummysmile, TADS, Segmental mechanics, Intrusion.


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