Aggravation of Gummy Smile by Straight‑Wire Mechanics and its Management with or without Orthognathic Surgery Up to 10‑Year Follow‑Up

Abstract

Two female patients presented with gummy smile, maxillary dentoalveolar protrusion and total vertical maxillary excess, retroclined incisors, and increased overbite received orthodontic camouflage with straight‑wire mechanics by general dentists. The treatments caused severe bowing of upper occlusal plane which aggravated the gummy smile and had led them to seek specialist care. They were successfully managed by orthodontic camouflage and combined surgical‑orthodontic treatment, respectively, in conjunction with the application of miniscrews on straight‑wire mechanics. Aggravation of gummy smile by straight‑wire mechanics, use of visual treatment objective to differentiate between orthodontic camouflage and surgical cases, and LeFort I segmentalization were discussed.