Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
Am J Orthod Dentofacial Orthop. 2020 Aug;158(2):273-285. doi: 10.1016/j.ajodo.2019.04.038. Epub 2020 Jun 30.
A gummy smile is one of the most problematic characteristics in patients with a Class II Division 2 malocclusion, and the correction of vertical position and incisor torque is often challenging for the orthodontist. This case report describes the orthodontic treatment of a 31-year-old woman, assisted by miniscrew mechanics for maxillary arch distalization and correction of a gummy smile with a brachyfacial pattern. Two different mechanics were used. Miniscrews were placed in both maxillary tuberosities, and the maxillary arch was successfully distalized, correcting the Class II relationship. Interradicular miniscrews were placed for maxillary and mandibular incisor intrusion to correct the gummy smile, overbite, and torque. Finally, periodontal surgery was performed to lengthen the maxillary incisor crowns. Satisfactory smile esthetics and good occlusion were achieved. Follow-up after 24 months confirmed that the outcome was stable.
深覆合患者中常见一种较为棘手的特征是露龈笑，对于正畸医生来说，垂直向位置和切牙转矩的矫正往往具有挑战性。本病例报告介绍了一位 31 岁女性的正畸治疗，通过微型种植体支抗辅助上颌骨远移，矫正短面型深覆合伴露龈笑。采用了两种不同的力学机制：在上颌结节中分别植入微型种植体，成功实现了上颌骨远移，矫正了 II 类错合关系。在上颌和下颌切牙植入根管内微型种植体，以矫正露龈笑、深覆合和转矩。最后，进行牙周手术以增加上颌切牙的冠长。获得了满意的微笑美学效果和良好的咬合关系。24 个月的随访证实，治疗效果稳定。
