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

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

Open Access
|Mar 2023

Figures & Tables

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_

VariableNormPretreatmentPosttreatment
SNA,°82.876.276.0
SNB,°80.171.973.0
ANB,°2.74.33.0
Wits appraisal, mm0.00.8-3.3
SN-GoGn,°32.538.236.0
U1-NA,°22.832.217.8
UI-NA, mm5.08.53.5
L1-NB,°30.33125.9
L1-NB, mm7.08.04.2
FMA(MP-FH),°30.1929.027.5
IMPA(L1-MP),°95.59100.595.5
FMIA(L1-FH),°57.8150.557.0
Interincisal angle,°124.2118.1137.0
Upper lip to E-line, mm-4.03.00.5
Lower lip to E-line, mm-2.07.03.0
Nasolabial angle,°110.077.090.0

The overcorrection: extra crown angulation_

Tooth positionRight Maxillary CanineRight Maxillary Second PremolarLeft Maxillary CanineLeft Maxillary Second PremolarRight Mandibular CanineRight Mandibular Second premolarLeft Mandibular CanineLeft Mandibular Second Premolar
Mesial crown angulation
Distal crown angulation
DOI: https://doi.org/10.2478/aoj-2023-0011 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 96 - 108
Submitted on: Oct 1, 2022
Accepted on: Jan 1, 2023
Published on: Mar 15, 2023
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year

© 2023 Yu Hua Chen, Yuan Gao, Jiao Jiao He, Shan Min Fu, Lei Wang, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.