Case details

Category

“Gummy smile”, worn teeth, lost posterior teeth, diastemas crossbite.

Case description

In this case, the interdisciplinary collaboration of orthodontics and prosthetics comes to its maximum expression. The posterior teeth were lost, and implant-prosthetic rehabilitation was needed. Additionally, the patient had a crossbite, worn teeth, gaps between teeth, and excessive visibility of the gums when smiling, known as a “gummy smile.” In individuals who do not have missing teeth, the problem of a “gummy smile” can be addressed through orthodontic mini-implants or orthognathic jaw surgery.

Since orthognathic surgery is quite an invasive procedure, patients often want to avoid it, and in our clinic, we usually resolve such cases using orthodontic mini-implants and fixed orthodontic therapy. However, in this specific case, we approached it differently.

The dental implants, which were later used as supports for the crowns of the missing teeth, were initially utilized as anchors to move the entire upper dental arch upward with a fixed orthodontic appliance and resolve the “gummy smile” issue. Therefore, it was necessary to place the dental implants precisely at certain locations that would correspond to the position of the remaining teeth after they were moved.

At the end of the orthodontic therapy, specific spaces were left to allow for a prosthetic and minimally invasive shaping to achieve a beautiful appearance of the teeth and gums.

The orthodontic therapy was conducted by orthodontist specialist Marko Grgurić, and the prosthetic part of the therapy with veneers was carried out by Željko Kovač, DMD.