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Josie: too much of the teeth showing, gummy smile, implants.

Facial diagnosis

  • Receding lower jaw
  • Too long upper jaw

Dental diagnosis

  • Class II division 1

Treatment jaw surgery

  • Shortening upper jaw (intrusion upper jaw - Le Fort I)
  • Chin surgery (Sliding genioplasty)

Treatment dental implants

  • Implant supported bridge (fixed denture) upper jaw

About this case

Josie is in her early 30s. Her gingival smile makes her unhappy. She lost some teeth and she clearly has a long face, with a gingival smile due her VMH (Vertical Maxillary Hyperplasia) – too long upper jaw.

There were two options:

  • Le Fort I with vertical shortening of the upper jaw, and further rehab with implants in the back zone upper and lower.
  • Extraction, alveolar reduction and levelling of her upper jaw bone 8 mm higher (instead of a Le Fort I intrusion) and placing the implant at a bony level higher than her laugh line.

Sandra chose the second option. So basically we corrected her gummy smile by reducing her alveolar bone upwards following the teeth extraction.

For aesthetic reasons we performed a chin surgery as well. An immediate loading was performed the same week with chrome-cobalt resin and in the near future it will be changed into zirconium porcelain. Josie is delighted by the result. Her face is much more relaxed, her facial flow is nice and natural and her smile is gorgeous.