Esthetics and Anterior Tooth Position: An Orthodontic Perspective Part II: Vertical Position

This article discusses the vertical position of the maxillary incisors and its relationship to esthetics. Two situations are discussed. The first, a discrepancy between the incisal plane and the interpupillary line, is corrected by maxillary surgery, orthodontic intrusion/extrusion, or orthodontics and restorative dentistry. The correct decision depends on the interrelationship of the posterior occlusal plane, incisal plane, interpupillary line, and the crown length of the incisors. The second discrepancy in the vertical position of the maxillary incisors is the “gummy” smile. This problem, due to either overdevelopment of the entire maxilla or over‐eruption of the maxillary incisors, is solved by maxillary surgery, orthodontic intrusion of the over‐erupted teeth, or orthodontics and restorative dentistry. The proper choice of treatment depends on the interrelationship of the posterior occlusal plane, incisal plane, crown length of the maxillary incisors, and the level of the gingival margins of the maxillary anterior teeth.