New article published in this month's Orthotown
The case underscores the importance of occlusal plane control in Class II high-angle malocclusion cases with excessive gingival display.
It also demonstrates how Integrating orthodontic biomechanics with digital smile design and soft tissue refinements achieves optimal functional and aesthetic outcomes.
The article also highlights how advanced biomechanics and aesthetic-driven treatment planning can create life-changing transformations beyond just dental alignment and improve the patients overall wellness.
ARTICLE HIGHLIGHTS
Patient Overview
28-year-old female, presented with a high-angle Class II malocclusion characterized by:
o Skeletal discrepancies: Small, retrognathic mandible, constricted dental arches, steep occlusal planes.
o Dental issues: Protruded upper incisors, upper arch crowding, and slight lower arch crowding.
o Aesthetic concerns: Gummy smile, everted lower lip, and strained lip competence.
Diagnosis & Treatment Goals
Address skeletal and dental issues while maintaining a conservative, non-surgical approach.
Adjust occlusal planes to improve the patient’s facial and smile aesthetics.
Optimize both white and pink aesthetic parameters (teeth alignment and gum display).
Treatment Strategy
TAD-Assisted Maxillary Intrusion:
o Used four mini-screws to intrude the maxilla and allow counterclockwise mandibular rotation.
Self-Ligating Appliance (Pitts21, OC Orthodontics):
o Progressive wire sequencing (NiTi and stainless steel) to achieve alignment and occlusal plane control.
Elastic Mechanics:
o Class III elastics and reverse rainbow elastics to control lower incisor flaring and counteract mandibular rotation.
Arch Expansion & Slenderizing:
o Relieved crowding and improved dental proportions.
Soft Tissue Revisions:
o Diode laser gingivectomy to refine the gum line for optimal smile aesthetics.
Clinical & Aesthetic Outcomes (28-Month Treatment Duration)
Dental Results:
o Achieved Class I molar and canine relationships.
o Controlled occlusal planes, reducing gingival display and improving smile dynamics.
Skeletal & Facial Improvements:
o Counterclockwise rotation of the mandible and occlusal plane, leading to better chin projection and facial balance.
Soft Tissue Enhancements:
o Laser gingivectomy refined gum aesthetics, and teeth whitening further enhanced smile appearance.
Post-Treatment Stability:
o No relapse in occlusion or aesthetics one year after treatment.
o Patient reported increased self-confidence and 20 kg (44 lbs) weight loss, highlighting the holistic impact of orthodontic wellness care.
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