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KMID : 1149720220120020165
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Clinical Journal of Korean association of Orthodontists
2022 Volume.12 No. 2 p.165 ~ p.178
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Efficient Treatment Strategy for Vertical Control in a Protrusive High Angle Patient with Vertical Maxillary Excess and Gummy Smile
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Kang Si-Won
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Abstract
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In the treatment of a hyperdivergent patient, making sufficient facial change without surgery is challenging because the chin is retrusive, rotated backwardly. The patient may be still protrusive after the treatment if sagittal retraction is only performed. Since the mandible moves in a rotational manner, vertical control can result in significant sagittal correction in profile through the autorotation of the mandible. Since the orthodontic mini-implant is a very effective tool for vertical control, especially, for intrusion, it can play a crucial role in making facial change for a hyperdivergent patient. A 24-year-old girl was presented with chief complaints of protrusion and gummy smile. Her profile showed protrusion, lip incompetency and very retrusive chin. She showed excessive gingival display during smiling. Her diagnosis included skeletally hyperdivergent Class II pattern, anteriorly and vertically excessive maxilla. The patient was treated with total arch intrusion in maxilla and mandible using two orthodontic mini-implants for each arch. Total arch intrusion in both arches created counter-clockwise autorotation of the mandible which dramatically improved her profile. Intrusion in the maxillary anterior region decreased excessive gingival display and made an attractive smile for the patient.
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KEYWORD
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Hyperdivergent, Protrusion, Gummy smile, Vertical maxillary excess, Orthodontic mini-implant
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