장안모 및 Gummy Smile을 가진 환자에서 전체 치열의 압하와 후방 이동을 통한 교정치료 증례

Orthodontic Correction for a Patient with a Long Face and Gummy Smile through Total Intrusion and Distalization: A Case Report

The goals of orthodontic treatment are to improve both dental function and facial aesthetics. One key element of aesthetics is the smile, and excessive gingival exposure in the maxillary anterior region, known as ‘gummy smile,’ can lead to an unesthetic appearance. Gummy smile caused by dentoalveolar protrusion and/or extrusion are indications for orthodontic treatment with retraction and/or intrusion of the anterior teeth. However, traditional methods pose challenges due to anchorage limitations and the need for patient compliance. These difficulties have been addressed with the use of skeletal anchorage, such as orthodontic miniscrews. A 19.5-year-old female patient presented with concerns of a long face, lip incompetency, and gummy smile. Clinical examination revealed a Class I molar relationship, mild crowding, and bialveolar protrusion. Non-extraction orthodontic treatment using fixed appliances and orthodontic miniscrews was employed for total intrusion and distalization of both the upper and lower arch. After 15 months, the patient achieved good occlusion and significant aesthetic improvement, including correction of the gummy smile and vertical reduction of the facial height. This case report outlines the treatment process and discusses the biomechanical considerations involved in total arch intrusion and distalization. (Clin J Korean Assoc Orthod 2024;14(4):292-303)