Gummy smile treatment options depend on what’s causing it and how severe the problem is.  While orthodontists rate 2–3 mm of gingival exposure as unattractive, general dentists, and laypeople feel that >4 mm is required to rate a smile as unattractive [Figure 3]. During the consult, the 45-year-old female patient said her chief concern was crowding of the lower front teeth and a flared appearance of the upper lateral incisors. Basically, a gummy smile is when the ratio of your lips, gums and teeth is not balanced. The total treatment time for this case was 22 months. It is for this reason that many people with a gummy smile or excessive gingival display feel their smile to be unattractive, oftentimes feeling reluctant to smile at all. The laser allowed us to uncover the teeth quickly without waiting on the gums to remodel spontaneously. With TADS, Dr. Karen Guinn places them into the top or bottom gum, depending on what movement is needed. Attempting to correct an overbite or gummy smile without also considering the relationship between the incisor and lip while at rest. This makes TADs more comfortable and easy to remove by the dentist. Extraction cases with gummy smile are recognized as challenging malocclusions for clear aligner treatment. In addition, distal root movement for all teeth in the maxillary buccal segments was needed. An excessive display of gingival tissue on smiling (i.e. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. The Invisalign system is the virtually invisible way to straighten your teeth and achieve the smile you’ve always wanted. Despite the patient’s compliance in wearing aligners and elastics, there was Class II “window” along the distal incline of the incisal edge of both maxillary canines which extended posteriorly for all the interproximal intercuspation in the buccal segment [Figure 11]. ... (TAD) Temporary anchorage devices, or TADs, are small titanium anchors used in certain orthodontic cases to help achieve quicker tooth movement with more efficiency and comfort. Realistic assessment of the 3D biomechanics relative to IZC anchorage for aligner treatment is not possible without FEA of CBCT images. Basically, a gummy smile is when the ratio of your lips, gums and teeth is not balanced.  The force system for G6 is indeterminate mechanics which are not intuitive. Gorton received the American Association of Orthodontics Award for Craniofacial Research and the Harvard Odontological Society Award for Excellence in Research. One of the benefits of prescribing AcceleDent is the increased predictability of the tracking of the tooth movement in the aligners, which is particularly important in a case with complex auxiliaries such as this patient. Summary. Invisalign has been a big thing in the orthodontic realm for several years. This payment flexibility together with clinical acceleration assists us in meeting patient demand for excellent results in a more efficient timeframe while maintaining a fee equitable to the results obtained.  The retraction of incisors was less than predicted, and there were multiple side effects such as lingual tipping and extrusion. The patient accepted the extraction treatment plan which involved: (1) Two 2 mm × 12 mm OBSs installed bilaterally in the infra-zygomatic crest (IZC), (2) two additional 1.5 mm × 8 mm Incisal OBSs in the maxillary anterior inter-radicular (I-R) region between central and lateral incisors bilaterally, (3) elastics (Ormco Corporation, Brea, CA) hooked on the bone screws to retract and intrude the maxillary anterior segment, and (4) IPR to address a Bolton discrepancy between the arches. (We spent 10 of those months intruding.) Gummy smile can occur due to many reasons such as vertical maxillary excess, excessive gingival overgrowth, altered passive eruption, anatomically short upper lip, hypermobile muscles of the upper lip, or a combination of any of these factors. I am getting braces, lingual on the top and regular on the bottom. The authors feel this approach may evolve to be the “gold standard” for patients who demand inconspicuous aligner therapy for demanding malocclusions requiring extractions in all four quadrants. Over the past few years of using AcceleDent’s SoftPulse Technology for virtually all of our Invisalign patients, we have been able to eliminate nearly all of the “overcorrections” we used to program into the ClinCheck software. Go PRO. OrthoBoneScrew ® (OBS) anchorage is designed to augment the Invisalign ® clear aligner G6 solution to produce more predictable outcomes as illustrated by the current case report. There are various treatment options for eliminating a gummy smile. Gummy Smile Treatment - This can either be treated by intruding the entire upper arch with TADs, or by moving the upper jaw surgically. I never had a gummy smile, but it seams like it's slightly more noticeable. , One of the more challenging clinical scenarios for aligners is the treatment of extraction cases. 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