Efficacy Analysis Of The Application Of Micro-implants In The Treatment Of Gummy Smile With Different Vertical Facial Types

Background and PurposeThe methods of orthodontic treatment of gummy smile include segmental arch,multi-purpose arch,J hook high traction,implant anchorage technology,orthodontic-orthognathic combined treatment,etc.Implant anchorage technology is relatively simple and convenient to operate,it is comfortable and eutherapeutic for patients,and it’s low risk,because of these reasons,implant anchorage technology often becomes the first choice for doctors and patients.However,when implant anchorage is used to treat gummy smile,the effect is often different in different patients.When the same amount of force was applied to the anterior teeth of patients with gummy smile,some patients had obvious anterior teeth depression and they were significantly effective,while other patients need more time to achieve the same effect,and sometimes even need to increase the force to depress the anterior region.This topic chooses to explore the effect of the bone mineral density in anterior teeth on the depression of the upper anterior teeth.Since there are few studies conduct grouping experiments on the bone mineral density of the maxillary anterior teeth at home and abroad,and the BMD of the anterior teeth of the patients with different vertical facial types was different in domestic study,that is,the BMD of the anterior teeth of the low-angle type>the BMD of the anterior teeth of the equal-angle type>the BMD of the anterior teeth of the high-angle type.Therefore,in this study,the vertical facial type was used as the grouping standard to explore the therapeutic effect of using micro-implants assisted treatment gummy smile in patients with different vertical facial types,which is expected to have guiding significance in clinical practice.MethodsAccording to the patient inclusion criteria for this study,patients who received orthodontic treatment in the Second Affiliated Hospital of Harbin Medical University with gummy smile were selected,and micro-implants were implanted in the alveolar bone of the anterior teeth area to depress anterior teeth and improve gummy smile.In this study,the patients were divided into three groups based on the vertical facial type,namely high-angle group,average-angle group,and low-angle group,each group was loaded with a force value of 100g.Before and after treatment,CBCT images were taken to analyze the movement of the upper anterior teeth depressions,and investigate the therapeutic effect of implant anchorages assisted treat gummy smile in patients with different vertical facial types.Finally,the SPSS26.0 software was used for statistical analysis of the experimental data.ResultsThe maxillary central incisors of the three groups of experiments were depressed for three months,and the experimental data differences before and after the experiment were statistically significant（P<0.05）.Compared with before treatment,the depression of the left upper central incisor in group A was 2.67±0.20 mm,the depression in group B was 2.43±0.07 mm,and the depression in group C was 2.24±0.19 mm,and there were statistically significant differences in depressions among the three groups（P=0.000）,that is,the depression amount in the high-angle group>the depression amount in the average-angle group>the depression amount in the low-angle group.The labial inclination of the left upper central incisor in group A was1.77±0.88°;the labial inclination of the left upper central incisor in group B was1.76±1.04°;the labial inclination of the left upper central incisor in group C was1.63±1.09°.The difference was not statistically significant（P<0.05）.In Group A,L-L’was 1.13±0.22mm,L_root-L_root’was 1.08±0.21mm;In Group B,L-L’was 0.86±0.15mm,L_root-L_root’was 0.82±0.26mm;In Group C,L-L’was 0.74±0.22mm,and L_root-L_root’was0.75±0.21mm.There were statistically significant differences in the root resorption of the left upper central incisor among the three groups（P=0.001,P=0.010）.that is,the root resorption in the high-angle group>the root resorption in the average-angle group>the root resorption in the low-angle group.The labial alveolar bone resorption of the left upper central incisor in group A was 1.03±0.89mm;the resorption in group B was 1.00±1.11mm;the resorption in group C was 0.69±0.26mm.The difference in absorption was not statistically significant（P<0.05）.Conclusions1.Micro-implants can effectively depress the maxillary central incisors,and the teeth are accompanied by a certain degree of labial tilt.2.The labial alveolar bone was slightly absorbed during the depression of the maxillary central incisor.3.The maxillary central incisor has slight root resorption when the implant is placed between the maxillary central incisor and the lateral incisor and applied 100g force depresses the maxillary anterior teeth.4.The vertical facial types affect the depression effect of the upper central incisor and the degree of root resorption.When comparing the depression amount of maxillary central incisors under the same force value,high-angle group>average-angle group>low-angle group;when comparing the degree of root resorption,high-angle group>average-angle group>low-angle group.