Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case

Abstract

In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.

Uso de mini-implantes para el tratamiento de sonrisa gingival. Revisión de la literatura.

“…La terapia mas eficaz para discrepancia esquelética, incluído una retrusión mandibular es la cirugía ortognática pero por el costo, los riesgos expuestos se debe estimar una terapia alternativa para lograr intrusión de los incisivos maxilares. (Falahi et al, 2012;Nishimura et al, 2014;Wang et al, 2016) Actualmente, el uso de mini-tornillos es significativo para conseguir el adedcuado control vertical, de manera que la intrusión de los molares ocasiona que la mandíbula gire en sentido contrario a las agujas del reloj, lo cual corrige mordida abierta anterior y su vez mejora el perfil; así mismo, al intruir los incisivos maxilares es posible corregir una sonrisa gingival y una verdadera intrusión, en casos raros se necesita un control vertical tanto del segmento anterior como del posterior.…”

Introducing surface-to-surface matching technique to evaluate mandibular symmetry: A retrospective study

“…Micro-screws were placed in the anterior and posterior segments of the upper jaw. This method reduced deep overbite, corrected the scissor bite, and helped the mandibular plane's counterclockwise rotation, thereby improving facial profile [ 39 ]. For severe scissor bite, multiple teeth are involved.…”

Treatment of vertical maxillary excess without open bite in a skeletal Class II hyperdivergent patient

“…It included one miniscrew connected with four power arms. Lin et al 5 and Wang et al 17 used five to six miniscrews on the buccal or palatal side or both sides for intrusion and retraction of the anterior teeth. In addition, some articles 7,18 reported cases with a gummy smile in which autorotation of the mandible did not occur as planned because simultaneous extrusion of the mandibular molar had occurred.…”