Can Orthodontics fix
Braces can reposition your teeth and can treat gummy smile.
There are many reasons for gummy smile. Therefore, proper analysis, diagnosis, and treatment planning by the specialist orthodontist is required before the start of treatment.
Prof. Irfan Qamruddin BDS FCPS PhD (Malaysia)
reasons for Excessive visibility of gums
Many patients visit dentists with complain of excessive visibility of gums on top of their teeth and in dental terminology we call it gummy smile. Patients with gumy smile are self-conscious. We should keep in mind that there is not only one reason for excessive visibility of gums and therefor there is not only one treatment option for this problem. The cause of the gummy smile can be multifactorial and must be accurately diagnosed to render appropriate treatment.
How to diagnose the exact etiology of gummy smile?
It is very important to do a proper diagnosis before starting treatment because these cases are difficult to treat and when a dental surgeon tries to treat them without proper planning, then it is almost impossible to achieve a desirable outcome that results in unsatisfied patients.
In this video Prof. Irfan Qamruddin effortlessly explained how to diagnose gummy smile properly.
A published case of prof. Irfan Qamruddin
Gummy Smile Patient Treated Nonsurgically
A 16-year-old female patient came with the presenting complaint of protrusion along with excessive visibility of upper incisors and excessive display of gums on smiling.
There was no significant medical history while dental history revealed her visit to a local general dentist 2 years ago with the same complaint where she was treated by trimming of her incisors to reduce visibility.
Ideal treatment plan offered to the patient and that was
The ideal treatment plan offered to the patient was the subapical segmental osteotomy in the upper jaw to move the whole anterior maxillary segment upward and backward with surgical mandibular advancement in the lower jaw.
The patient rejected the surgical plan; therefore alternate treatment plan was followed.
extraction of maxillary first premolars
nonextraction treatment in lower arch
class II molar and class I canine relationship
In between treatment
The treatment was started with banding and bonding procedure using 0.022 slot preadjusted edgewise brackets, MBT prescription. Vertical placement of brackets on central and lateral incisors was kept at the same level so that the incisal edges can be restored after the treatment. Alignment and leveling were achieved with continuous archwire used in the following sequence: 0.012 Niti, 0.016 Niti, 0.017 × 0.025 Niti followed by 0.017 × 0.025-in SS wire. Extractions of upper first premolars were carried out along with insertion of mini implant in the same appointment. Self-drilling type of titanium mini implants (1.4 mm diameter and 8 mm length) was inserted between the roots of upper first molar and second premolar bilaterally. Implants were loaded immediately with elastomeric chain to retract the canine first into class I relation. After achieving class I cuspid relationship bilaterally, NiTi closed coil springs were extended from implants up to the helix formed in the archwire distal to the lateral incisors on both sides. Force of 150 gm was applied (measured with Dentus gauge) with the force vector passing above the CRes of maxilla, so that the anterior teeth are retracted upward and backward (Figure 2). Forces were repeated after every three weeks till the extraction spaces are completely closed.
this treatment ended after 27 months
Orthodontic treatment duration varies case to case. the average orthodontic treatment lasts around two years.
However, orthodontists can repair more moderate issues in as little as six months while more complex issues can take 3 years or more.
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consider Prof. Irfan Qamruddin
First Floor, 8th Commercial Street, hall no.1, Zamzama Commercial Area Defence V Karachi, Karachi City, Sindh 75600
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