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Case Reports
. 2012 Jan;82(1):170-7.
doi: 10.2319/020711-86.1.

Gummy smile and facial profile correction using miniscrew anchorage

Masato Kaku  1 , Shunichi Kojima, Hiromi Sumi, Hiroyuki Koseki, Sara Abedini, Masahide Motokawa, Tadashi Fujita, Junji Ohtani, Toshitsugu Kawata, Kazuo Tanne
Affiliations
Case Reports

Gummy smile and facial profile correction using miniscrew anchorage

Masato Kaku et al. Angle Orthod. 2012 Jan.

Abstract

This case report describes the treatment of a case involving a skeletal Class II facial profile with a gummy smile. While treating a facial profile and a gummy smile, the outcome may not always be successful with orthodontic therapy alone. For this reason, surgical therapy is often chosen to gain an esthetic facial profile and a good smile. However, sometimes the patients reject surgical treatment and an alternative method must be considered. Skeletal anchorage systems such as miniscrews are now frequently used for correcting severe malocclusion that should be treated by surgical therapy. In this case report, we treated a skeletal Class II malocclusion with a convex profile and a gummy smile using miniscrews, which were placed in the upper posterior and anterior areas. The active treatment period was 3.5 years, and the patient's teeth continued to be stable after a retention period of 36 months.

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Figures

Figure 1
Figure 1
Pretreatment facial photographs.
Figure 2
Figure 2
Excessive gingival display before treatment.
Figure 3
Figure 3
Pretreatment intraoral photographs.
Figure 4
Figure 4
Pretreatment panoramic radiograph.
Figure 5
Figure 5
Retraction of first premolars by miniscrew anchorage.
Figure 6
Figure 6
Distalization of the upper left first molar by open coil spring from first premolar, which was connected tightly with a miniscrew (upper left second molar was removed).
Figure 7
Figure 7
Placement of miniscrews in the maxillary bone above the root apices.
Figure 8
Figure 8
Surgical procedure for miniscrew insertion in the maxillary bone.
Figure 9
Figure 9
Intrusion of upper incisors with direct miniscrew anchorage.
Figure 10
Figure 10
Posttreatment intraoral photographs.
Figure 11
Figure 11
A clear retainer combined with the anterior miniscrews.
Figure 12
Figure 12
Posttreatment facial photographs.
Figure 13
Figure 13
Posttreatment panoramic radiograph.
Figure 14
Figure 14
Cephalometric superimposition (pretreatment and posttreatment).
Figure 15
Figure 15
Posttreatment facial smile photographs.
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