Surgical-Orthodontic Treatment of Gummy Smile with Vertical Maxillary Excess

Yadav, Sumit; Sehgal, Vikas; Mittal, Sanjay

doi:10.1177/0974909820140110

Cited by 5 publications

(3 citation statements)

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“…[3] Superior impaction of the maxilla through surgery is a modality chosen in cases where vertical excess of the maxilla has caused downward and backward rotation of the mandible and excessive tooth exposure at rest. [6] The patient in the above case had an excessive gummy smile and incisor exposure when at rest. This negatively affected the aesthetics.…”

Section: Discussionmentioning

confidence: 92%

Ortho-Surgical Management of An Adult Patient with Gummy Smile

et al. 2023

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Aim: This case report represents the clinical management of a Skeletal Class II adult patient with gummy smile treated by Orthognathic surgery. Background: Vertical maxillary excess (VME) is the most common skeletal deformity in Skeletal Class II which is treated by Anterior Maxillary Osteotomy (AMO) and Gummy Smile is the characteristic feature of VME in which the anterior part of maxilla is superiorly repositioned. Case Description: A 19-year-old patient reported our clinic with the complaint of forwardly placed upper front teeth. On extra oral examination, she had convex profile with posterior divergence and interlabial gap of 10mm and everted upper lip. The patient had a gummy smile of 8mm. Intra orally, she had Class II canine relationship on both sides with missing irt 16, 36, 46. Cephalometric values showed Class II skeletal base with protrusive upper and lower incisors and acute nasolabial angle. Initially orthodontic treatment was done and extraction of upper first premolars was planned during surgery. AMO was done with superior impaction of 4mm and posteriorly by 6mm. After 4 weeks of post surgery, the settling of occlusion using intermaxillary elastics was done. At the end of the treatment, the patient had Class I canine relationship on both sides with Skeletal Class I and overjet and overbite was 2mm. The patient gummy smile was reduced to 4mm which was accepted by the patient. Fixed retention was given in both the arches. The total treatment time was around 30 months. Conclusion: The proper diagnosis and appropriate treatment planning is the main key to achieve stable results in Orthodontics. An interdisciplinary approach with the orthodontist and surgeon will lead to achieve stable, functional and esthetic results.

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Section: Discussionmentioning

confidence: 92%

Ortho-Surgical Management of An Adult Patient with Gummy Smile

et al. 2023

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“…The main highlight of this comparative study is to report variants of long face with an increased facial height. Treatment plan: Superior impaction of maxilla is ideal for this case to address the excessive gummy smile, improve the smile arc by intrusion of the maxilla [16] . The smile arc can be improved along with the reduction of mandibular plane angle and reduction of facial height making it more towards an aesthetically pleasing face.…”

Section: Discussionmentioning

confidence: 99%

Characteristic Variants in Long Faces with Increased Anterior Facial Height

Solanki

K.K

2022

IJOrthoR

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Facial characteristics are affected by facial proportions, growth pattern, facial heights and smile of the patients. Long face syndrome usually presents with an increased lower anterior and total anterior facial height, a gummy smile, a hyperdivergent growth pattern and decreased facial height. However, there are many variations in the posterior facial height and the growth pattern. There can be patients having an increased anterior facial height with increased or average posterior facial height, or an average and reduced mandibular plane angle. This paper aimed at reviewing the various characteristic facial variants of an increased anterior facial height. This article reviews three such variants of an increased anterior facial height. It particularly highlights the variant with increased anterior and posterior facial height and the modification in the treatment of such cases. The most common treatment option for the normally occurring variant of hyperdivergent growth pattern with a reduced posterior facial height is surgical superior impaction.

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“…Para disminuir la exposición gingival se han empleado diferentes tratamientos, desde la aplicación de toxina botulínica (Dinker et al, 2014), el alargamiento de corona clínica (Cairo et al, 2012), la intrusión ortodóncica con el uso de microtornillos (Alshammery et al, 2021), el reposicionamiento labial (Bhola et al, 2015) y hasta la cirugía ortognática cuando la etiología principal es el exceso de crecimiento óseo vertical (Yadav et al, 2014).…”

Section: Introductionunclassified

Reposicionamiento Labial. Caso Clínico

Ginez-Vazquez,

Martínez-Gutiérrez,

Mayoral-García

2023

Int. J. Odontostomat.

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RESUMEN:El reposicionamiento labial es un procedimiento quirúrgico mínimamente invasivo que se utiliza para tratar una sonrisa gingival, la cual, es una afección en la que una cantidad significativa de la encía queda expuesta cuando una persona sonríe y puede deberse a una variedad de factores, como un exceso de tejido gingival, un labio superior corto o músculos hiperactivos del labio superior, entre otros. El alargamiento clínico de la corona, por otro lado, consiste en eliminar el exceso de tejido gingival y, si es necesario, el tejido óseo para exponer una mayor parte de la corona natural del diente. Se reporta un caso clínico de paciente femenino de 31 años que presentó una sonrisa gingival provocada por hipermovilidad de labio superior y un exceso de tejido gingival localizado. El plan de tratamiento involucró una combinación de reposicionamiento labial y alargamiento de corona. Los resultados estéticos fueron significativos, con la sonrisa del paciente más equilibrada y proporcionada. Se redujo la cantidad de tejido gingival expuesto cuando la paciente sonreía y la longitud de los dientes fue más visible, lo que dio como resultado una sonrisa de aspecto más natural, además de aumentar su aceptación al sonreír.PALABRAS CLAVE: sonrisa gingival, reposicionamiento labial, alargamiento de corona.

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Surgical-Orthodontic Treatment of Gummy Smile with Vertical Maxillary Excess

Cited by 5 publications

References 0 publications

Ortho-Surgical Management of An Adult Patient with Gummy Smile

Ortho-Surgical Management of An Adult Patient with Gummy Smile

Characteristic Variants in Long Faces with Increased Anterior Facial Height

Reposicionamiento Labial. Caso Clínico

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