Re: Gummy smile and facial profile correction using miniscrew anchorage by Masato Kaku, Shunichi Kojima, Hiromi Sumi, Hiroyuki Koseki, Sara Abedini, Masahide Motokawa, Tadashi Fujita, Junji Ohtani, Toshitsugu Kawata, and Kazuo Tanne. Angle Orthod. 2012;82:170–177
To: Editor, The Angle Orthodontist
At first we present our congratulations to the authors of the recent case report “Gummy smile and facial profile correction using miniscrew anchorage” published in the January 2012 issue of your journal. But we also have two questions about this case:
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How can 4 mm intrusion of incisors correct such an excessive gingival display during smiling? The author considered that the gummy smile was caused by overgrowth of anterior dentoalveolar heights without problem in the vertical positions of posterior teeth. It was a wrong diagnosis. The patient had a long face, the lower lip covered the maxillary canines and premolars during smiling and there was harmony of the occlusal plane between the anterior and the posterior segments. These indicated vertical maxillary excess (VME)1,2 was the etiology. We also thought that relax of maxillary labial muscle after the retraction might contribute to the correction of gummy smile.
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The author said there was no severe root resorption? Panoramic might not supply accurate information of root resorption.3 But we can easily identify there was severe root resorption of right central incisor and lateral incisor compared to the canine after treatment, which was caused by long term intrusion.