Gummy Smile and Dental Protrusion Ortho-surgical Approach: A Case Report

Background: A 26-year-old woman with Gummy Smile and Dental Protrusion was treated with extractive orthodontics combined with LeFort I Maxillary Impaction Osteotomy. Methods: The patient was treated with fixed orthodontic appliance and extractive therapy. After 18 months of pre-surgical orthodontic treatment, extraction gaps were closed, and a 1-jaw surgery was performed. Post-surgery orthodontic treatment led to improved facial aesthetics and occlusion. The total active treatment time was 23 months. Results: After surgery, the maxilla was acceptably impacted 5 mm at first incisor level and 5 mm at first molar level. The anti-clockwise rotation of the mandible allowed a4 mm pogonion advancement and a decrease of the mandibular plane angle of 11.3°. The post-treatment records show a great stability of the occlusion and a good aesthetics of the face two years after the end of the treatment. Conclusions: The combination of a LeFort I Osteotomy with orthodontic extraction therapy is a useful technique for a reliable superior repositioning of the maxilla and simultaneous control of dental proclination.