Dr. Johnny JL, Liaw completed his orthodontic training at National Taiwan University Hospital in 1994 and received his master degree in Chang Gung Medical University. He is now in private practice since 2002. He keeps on lecturing a clinical orthodontic course over 15 years and he is also a part time visiting staff in National Taiwan University Hospital. He served as the President of Taiwan Association of Orthodontists during 2013~2014 and also the chairman of Taiwan Board of Orthodontics during 2015~2016. He is now the consultant of Taiwan Association of Orthodontists.
Orthodontic Management of Adult Gummy Smile with TADs
Excessive gingival display during smile in adult patients was difficult to correct without orthognathic surgery in the past. With the applications of skeletal anchorage system, genuine incisor intrusion is feasible to help the correction of adult gummy smile. Differential diagnosis and various treatment options should be fully discussed to decide the appropriate treatment modality. After significant amount of upper incisor intrusion, there might be an adverse effect on the crown height and width ratio. Esthetic periodontal surgery (gingivectomy or crown lengthening procedure) would be indicated for restoring the appropriate crown height and width ratio and further reducing the excessive gingival display. Sometimes, alveoloplasty was also necessary for originally severe protrusion cases. Under the collaboration of anterior miniscrew anchorage and periodontal surgery, it greatly improves the possibility of orthodontic correction for gummy smile in adult patients.