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Digital lingual appliance combined with micro-screws for the treatment of a skeletal bimaxillary protrusion and ‘gummy’ smile

Yu Hua Chen
Yu Hua Chen
, 
Yuan Gao
Yuan Gao
, 
Jiao Jiao He
Jiao Jiao He
, 
Shan Min Fu
Shan Min Fu
 e 
Lei Wang
Lei Wang
   | 15 mar 2023
Australasian Orthodontic Journal's Cover Image
INFORMAZIONI SU QUESTO ARTICOLO
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Pubblicato online: 15 mar 2023
Pagine: 96 - 108
Ricevuto: 01 ott 2022
Accettato: 01 gen 2023
DOI: https://doi.org/10.2478/aoj-2023-0011
© 2023 Yu Hua Chen et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Pretreatment facial and intraoral photographs.
Pretreatment facial and intraoral photographs.

Figure 2.

Pretreatment dental models.
Pretreatment dental models.

Figure 3.

Pretreatment radiographs and tracing: (A) lateral cephalometric radiograph; (B) cephalometric tracing; and (C) panoramic radiograph.
Pretreatment radiographs and tracing: (A) lateral cephalometric radiograph; (B) cephalometric tracing; and (C) panoramic radiograph.

Figure 4.

Digital setup: simulation of the final occlusal relationship.
Digital setup: simulation of the final occlusal relationship.

Figure 5.

The lingual bracket system: 0.018”slot, vertical slots in the anterior brackets and horizontal slots in the posterior brackets.
The lingual bracket system: 0.018”slot, vertical slots in the anterior brackets and horizontal slots in the posterior brackets.

Figure 6.

The maxillary and mandibular teeth were levelled and aligned in 4 months.
The maxillary and mandibular teeth were levelled and aligned in 4 months.

Figure 7.

A micro-screw was inserted between maxillary central incisors in the mucogingival junction and assisted in intruding the anterior teeth.
A micro-screw was inserted between maxillary central incisors in the mucogingival junction and assisted in intruding the anterior teeth.

Figure 8.

Posttreatment facial and intraoral photographs.
Posttreatment facial and intraoral photographs.

Figure 9.

(A) pretreatment facial smile photograph; (B) posttreatment facial smile photograph: the ‘gummy’ smile was corrected after 3 months’ intrusion of the maxillary anterior teeth.
(A) pretreatment facial smile photograph; (B) posttreatment facial smile photograph: the ‘gummy’ smile was corrected after 3 months’ intrusion of the maxillary anterior teeth.

Figure 10.

(A) pretreatment facial profile photograph; (B–D) treatment facial profile photographs; (E) posttreatment facial profile photograph: the profile of the patient changed from convex to straight and a better-defined cervical-mental angle was created.
(A) pretreatment facial profile photograph; (B–D) treatment facial profile photographs; (E) posttreatment facial profile photograph: the profile of the patient changed from convex to straight and a better-defined cervical-mental angle was created.

Figure 11.

Posttreatment dental models.
Posttreatment dental models.

Figure 12.

Posttreatment radiographs and tracing: (A) lateral cephalometric radiograph; (B) cephalometric tracing; (C) panoramic radiograph.
Posttreatment radiographs and tracing: (A) lateral cephalometric radiograph; (B) cephalometric tracing; (C) panoramic radiograph.

Figure 13.

Cephalometric superimpositions of the initial (black), final (red) lateral cephalometric tracings: (A) centered on the cranial base; (B) centered on the palatal plane; (C) centered on the mandibular symphysis.
Cephalometric superimpositions of the initial (black), final (red) lateral cephalometric tracings: (A) centered on the cranial base; (B) centered on the palatal plane; (C) centered on the mandibular symphysis.

Figure 14.

(A) ribbon-wise arch wire; (B) traditional orthodontic wire: the ribbon-wise arch wire has a greater width than height in cross-section which makes the wire harder to bend in the vertical direction.
(A) ribbon-wise arch wire; (B) traditional orthodontic wire: the ribbon-wise arch wire has a greater width than height in cross-section which makes the wire harder to bend in the vertical direction.

Cephalometrio analysis.

Variable Norm Pretreatment Posttreatment
SNA,° 82.8 76.2 76.0
SNB,° 80.1 71.9 73.0
ANB,° 2.7 4.3 3.0
Wits appraisal, mm 0.0 0.8 -3.3
SN-GoGn,° 32.5 38.2 36.0
U1-NA,° 22.8 32.2 17.8
UI-NA, mm 5.0 8.5 3.5
L1-NB,° 30.3 31 25.9
L1-NB, mm 7.0 8.0 4.2
FMA(MP-FH),° 30.19 29.0 27.5
IMPA(L1-MP),° 95.59 100.5 95.5
FMIA(L1-FH),° 57.81 50.5 57.0
Interincisal angle,° 124.2 118.1 137.0
Upper lip to E-line, mm -4.0 3.0 0.5
Lower lip to E-line, mm -2.0 7.0 3.0
Nasolabial angle,° 110.0 77.0 90.0

The overcorrection: extra crown angulation.

Tooth position Right Maxillary Canine Right Maxillary Second Premolar Left Maxillary Canine Left Maxillary Second Premolar Right Mandibular Canine Right Mandibular Second premolar Left Mandibular Canine Left Mandibular Second Premolar
Mesial crown angulation 4° 5° 4° 4°
Distal crown angulation 4° 4° 5° 4°
eISSN:
2207-7480
Lingua:
Inglese
Frequenza di pubblicazione:
Volume Open
Argomenti della rivista:
Medicine, Basic Medical Science, other
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