Skeletal and Dental Alterations During Corticotomy Assisted Maxillary Teeth Intrusion in a Patient With Vertical Maxillary Excess: A Case Report
| Author | Affiliation | |
|---|---|---|
Kauno ortodontijos centras | ||
Kauno ortodontijos centras | ||
Stacevičius, M. | S'OS Orthognathic Surgery | |
| Date | Volume | Issue | Start Page | End Page |
|---|---|---|---|---|
2025-05-12 | 52 | Suppl. 28 | 495 | 496 |
Poster no. PC322
Background: Gummy smile is a common aesthetic concern for patients with vertical maxillary excess (VME), lip hypermobility (LH) and/or altered passive tooth eruption. When the primary cause is VME, usually a surgical-orthodontic treatment approach is necessary to achieve satisfactory results. However, the complex and invasive nature of this treatment may hinder the final outcome or it might be declined by the patient. This clinical report describes a less invasive periodontal-orthodontic treatment of a patient with gummy smile.
Description of the procedure: A 20-year-old female patient, systemically healthy, non-smoker and with excellent oral hygiene was diagnosed with skeletal VME, hyperdivergent profile and LH. Four temporary anchorage devices (TADs) were placed on the buccal surfaces of anterior and posterior teeth and a palatal anchorage device (PAD) was placed in the anterior palate area. Corticotomies with a piezosurgical instrument in the interradicular spaces were performed during the same visit. Immediate traction with elastics was performed through TADs, PAD and aligners. Orthodontic intrusion was carried out for 6 months, until the necessary teeth position was achieved.
Outcomes: Clinical and radiographic data were evaluated before the start of the intrusion and after the necessary effect was achieved. DICOM data was superimposed to achieve an overall skeletal alteration heatmap and measure changes in the marginal bone levels (MBL). Tooth segmentation was performed to evaluate the amount of root resorption (RR). Overall tooth intrusion of posterior teeth was 3.04 and 3.61 mm of the anterior teeth. MBL changes in teeth 17–14 varied from 1.58 to 5.36 mm (mean 3.05 mm), in teeth 13–23 it was 3.81 to 4.85 mm (mean 4.13 mm) and in teeth 24–27 it was 1.33 to 3.62 mm (mean 2.49 mm). Mean RR of the anterior teeth was 3.27 and 0.76 mm of the posterior teeth.
Conclusions: Implant-anchored total intrusion of maxillary teeth is a feasible technique to improve the aesthetic result in patients with VME.