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Total intrusion and distalization of the maxillary arch to improve smile esthetics

  • Baek, Eui Seon (Department of Orthodontics, Gangnam Severance Hospital, College of Dentistry, Yonsei University) ;
  • Hwang, Soonshin (Department of Orthodontics, Gangnam Severance Hospital, College of Dentistry, Yonsei University) ;
  • Kim, Kyung-Ho (Department of Orthodontics, Gangnam Severance Hospital, College of Dentistry, Yonsei University) ;
  • Chun, Chooryung J. (Department of Orthodontics, Gangnam Severance Hospital, College of Dentistry, Yonsei University)
  • Received : 2016.04.28
  • Accepted : 2016.07.20
  • Published : 2017.01.25

Abstract

This case report illustrates the successful treatment of a patient with skeletal Class II malocclusion and an unesthetic smile involving excessive gingival display and large buccal corridors. By applying dual buccal interradicular miniscrews, total intrusion of the maxillary dentition along with distalization was induced to improve both the occlusion and smile esthetics. In addition to the conventional cephalometric superimposition, three-dimensional superimposition was performed and evaluated to validate the treatment outcome.

Keywords

References

  1. Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000 1996;11: 18-28. https://doi.org/10.1111/j.1600-0757.1996.tb00179.x
  2. Chang CA, Fields HW Jr, Beck FM, Springer NC, Firestone AR, Rosenstiel S, et al. Smile esthetics from patients' perspectives for faces of varying attractiveness. Am J Orthod Dentofacial Orthop 2011;140:e171-80. https://doi.org/10.1016/j.ajodo.2011.03.022
  3. Hunt O, Johnston C, Hepper P, Burden D, Stevenson M. The influence of maxillary gingival exposure on dental attractiveness ratings. Eur J Orthod 2002;24:199-204. https://doi.org/10.1093/ejo/24.2.199
  4. An SM, Choi SY, Chung YW, Jang TH, Kang KH. Comparing esthetic smile perceptions among laypersons with and without orthodontic treatment experience and dentists. Korean J Orthod 2014;44:294-303. https://doi.org/10.4041/kjod.2014.44.6.294
  5. Hwang WS, Hur MS, Hu KS, Song WC, Koh KS, Baik HS, et al. Surface anatomy of the lip elevator muscles for the treatment of gummy smile using botulinum toxin. Angle Orthod 2009;79:70-7. https://doi.org/10.2319/091407-437.1
  6. Kim SJ, Kim JW, Choi TH, Lee KJ. Combined use of miniscrews and continuous arch for intrusive root movement of incisors in Class II division 2 with gummy smile. Angle Orthod 2014;84:910-8. https://doi.org/10.2319/080713-587.1
  7. Proffit WR, Phillips C, Turvey TA. Stability following superior repositioning of the maxilla by LeFort I osteotomy. Am J Orthod Dentofacial Orthop 1987;92:151-61. https://doi.org/10.1016/0889-5406(87)90370-2
  8. Parekh SM, Fields HW, Beck M, Rosenstiel S. Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen. Angle Orthod 2006;76:557-63.
  9. Baek MS, Choi YJ, Yu HS, Lee KJ, Kwak J, Park YC. Long-term stability of anterior open-bite treatment by intrusion of maxillary posterior teeth. Am J Orthod Dentofacial Orthop 2010;138:396.e1-9; discussion 396-8. https://doi.org/10.1016/j.ajodo.2010.04.023
  10. Kuroda S, Sakai Y, Tamamura N, Deguchi T, Takano-Yamamoto T. Treatment of severe anterior open bite with skeletal anchorage in adults: Comparison with orthognathic surgery outcomes. Am J Orthod Dentofacial Orthop 2007;132:599-605. https://doi.org/10.1016/j.ajodo.2005.11.046
  11. Deguchi T, Kurosaka H, Oikawa H, Kuroda S, Takahashi I, Yamashiro T, et al. Comparison of orthodontic treatment outcomes in adults with skeletal open bite between conventional edgewise treatment and implant-anchored orthodontics. Am J Orthod Dentofacial Orthop 2011;139(4 Suppl): S60-8. https://doi.org/10.1016/j.ajodo.2009.04.029
  12. Arai C, Choi JW, Nakaoka K, Hamada Y, Nakamura Y. Management of open bite that developed during treatment for internal derangement and osteoarthritis of the temporomandibular joint. Korean J Orthod 2015;45:136-45. https://doi.org/10.4041/kjod.2015.45.3.136
  13. Bechtold TE, Kim JW, Choi TH, Park YC, Lee KJ. Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews. Angle Orthod 2013;83:266-73. https://doi.org/10.2319/032212-123.1
  14. Sohn BW, Lee JG, Kim HS, Kim HS. Semilongitudinal study of growth and development of children aged 6 to 17 Part I: Growth and development of arch form. Korean J Orthod 1996;26:225-39.
  15. Burstone CJ, James RB, Legan H, Murphy GA, Norton LA. Cephalometrics for orthognathic surgery. J Oral Surg 1978;36:269-77.
  16. Ioi H, Kang S, Shimomura T, Kim SS, Park SB, Son WS, et al. Effects of buccal corridors on smile esthetics in Japanese and Korean orthodontists and orthodontic patients. Am J Orthod Dentofacial Orthop 2012;142:459-65. https://doi.org/10.1016/j.ajodo.2012.05.011
  17. Park YC. A morphologic study on straight wire bracket for Korean. Korean J Orthod 1991;21:481-93.
  18. Zachrisson BU. Buccal uprighting of canines and premolars for improved smile esthetics and stability. World J Orthod 2006;7:406-12.
  19. Schendel SA, Carlotti AE Jr. Variations of total vertical maxillary excess. J Oral Maxillofac Surg 1985;43:590-6. https://doi.org/10.1016/0278-2391(85)90126-0
  20. Choi YJ, Lee JS, Cha JY, Park YC. Total distalization of the maxillary arch in a patient with skeletal Class II malocclusion. Am J Orthod Dentofacial Orthop 2011;139:823-33. https://doi.org/10.1016/j.ajodo.2009.07.026
  21. Kim SJ, Choi TH, Baik HS, Park YC, Lee KJ. Mandibular posterior anatomic limit for molar distalization. Am J Orthod Dentofacial Orthop 2014;146: 190-7. https://doi.org/10.1016/j.ajodo.2014.04.021
  22. Lee KJ, Joo E, Kim KD, Lee JS, Park YC, Yu HS. Computed tomographic analysis of tooth-bearing alveolar bone for orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop 2009;135:486-94. https://doi.org/10.1016/j.ajodo.2007.05.019
  23. Jeong GM, Sung SJ, Lee KJ, Chun YS, Mo SS. Finite-element investigation of the center of resistance of the maxillary dentition. Korean J Orthod 2009;39:83-94. https://doi.org/10.4041/kjod.2009.39.2.83
  24. Sung EH, Kim SJ, Chun YS, Park YC, Yu HS, Lee KJ. Distalization pattern of whole maxillary dentition according to force application points. Korean J Orthod 2015;45:20-8. https://doi.org/10.4041/kjod.2015.45.1.20
  25. Shafiee R, Korn EL, Pearson H, Boyd RL, Baumrind S. Evaluation of facial attractiveness from endof-treatment facial photographs. Am J Orthod Dentofacial Orthop 2008;133:500-8. https://doi.org/10.1016/j.ajodo.2006.04.048
  26. Yamada K, Kuroda S, Deguchi T, Takano-Yamamoto T, Yamashiro T. Distal movement of maxillary molars using miniscrew anchorage in the buccal interradicular region. Angle Orthod 2009;79:78-84. https://doi.org/10.2319/020408-68.1
  27. Proffit WR. The third stage of comprehensive treatment: finishing. In: Proffit WR, Fields HW Jr, Sarver DV, eds. Contemporary orthodontics. 5th ed. St. Louis: Elsevier Health Sciences; 2014. p. 596-7.
  28. Murakami T, Yokota S, Takahama Y. Periodontal changes after experimentally induced intrusion of the upper incisors in Macaca fuscata monkeys. Am J Orthod Dentofacial Orthop 1989;95:115-26. https://doi.org/10.1016/0889-5406(89)90390-9
  29. Melsen B. Tissue reaction following application of extrusive and intrusive forces to teeth in adult monkeys. Am J Orthod 1986;89:469-75. https://doi.org/10.1016/0002-9416(86)90002-3
  30. Han G, Huang S, Von den Hoff JW, Zeng X, Kuijpers-Jagtman AM. Root resorption after orthodontic intrusion and extrusion: an intraindividual study. Angle Orthod 2005;75:912-8.
  31. Choi YJ, Kim KH, Lee KJ, Chung CJ, Park YC. Radiographic evaluations of molar intrusion and changes with or without retention in rats. Angle Orthod 2011;81:389-96. https://doi.org/10.2319/060510-307.1
  32. Chung CJ, Choi YJ, Kim KH. Approximation and contact of the maxillary central incisor roots with the incisive canal after maximum retraction with temporary anchorage devices: Report of 2 patients. Am J Orthod Dentofacial Orthop 2015;148:493-502. https://doi.org/10.1016/j.ajodo.2015.04.033

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