Treatment of vertical maxillary excess without open bite in a skeletal Class II hyperdivergent patient

Abstract

A 20-year-old woman visited the office complaining of a gummy smile and lip protrusion. She was diagnosed with vertical maxillary excess without open bite and skeletal Class II hyperdivergent pattern. She refused the surgical-orthodontic treatment option, although she wanted to correct the gummy smile and retruded chin. Differential intrusion of anterior and posterior teeth in both arches was necessary to maximize the skeletal treatment effects. In the maxilla, one palatal temporary anchorage device (TAD), an archwire with an accentuated curve of Spee, and a transpalatal arch were applied. In the mandible, an archwire with a reverse curve of Spee and two vertically positioned TADs were used. These simple mechanics contributed to the effective intrusion of the total upper and lower arches, correction of the gummy smile, and mandibular counterclockwise rotation, offering an alternative to orthognathic surgery for this patient. (Angle Orthod. 2017;87:625-633).