Orthodontic treatment for protruding teeth and asymmetric teeth alignment

Hello.

I'm Dr. Son Su-min, an orthodontic specialist who has been practicing at Guardians Dental Myeongdong for 20 years.

My front teeth are protruding and my teeth look slanted when I smile

In cases where a protruding jaw and tooth asymmetry occur together, simply aligning the front teeth may not be enough.

The angle and movement space of the upper front teeth, as well as the height and width of the teeth, the bite of the upper and lower teeth, and the balance of the lips and face, must all be considered.

Today, I will introduce the orthodontic treatment process for a patient with a Class II Division 1 malocclusion and skeletal asymmetry.

These are the patient's photos at the time of the visit

What problems did the patient have before treatment?

The first thing observed when the patient visited was the forward inclination of the upper front teeth.

The upper front teeth were tilted forward beyond the normal range, making the mouth look relatively protruding in profile.

Looking at the bite of the upper and lower molars, the characteristics of a Class II Division 1 malocclusion could also be confirmed.

When viewed from the front, the midlines of the upper and lower teeth did not match, and there were differences in the height and arrangement of the teeth on both sides.

The occlusal plane also had a vertical asymmetry that was tilted to one side.

When diagnosing such cases at Guardians Dental Myeongdong, we do not simply judge them as a single problem of "crooked teeth".

We analyze the degree of protrusion and angle of the upper front teeth, the horizontal distance between the upper and lower teeth, the height and occlusal relationship of the teeth on both sides, the width and shape of the upper dental arch, and the degree of lip protrusion and facial asymmetry to determine the treatment direction.

What is a Class II Division 1 malocclusion?

A Class II Division 1 malocclusion refers to a condition where the upper teeth are relatively positioned in front of the lower teeth, and the upper front teeth are protruding forward.

Patients often visit with the following concerns:

My upper front teeth are protruding

There is a large gap between my upper and lower teeth

My lips do not close comfortably

My mouth looks protruding in profile

My upper teeth look particularly prominent when I smile

However, not all patients with a Class II Division 1 malocclusion require the same treatment.

There are cases where the upper jaw is protruding, cases where the lower jaw is positioned backward, and cases where the angle of the teeth is the main cause.

Therefore, when looking for Guardians Dental Myeongdong, it's a good idea to check if they analyze not only the teeth but also the skeletal and facial soft tissues.

The reason why the teeth seemed to be tilted to one side

When connecting the incisal edge of the front teeth and the occlusal surface of the molars from the front, the teeth were not horizontal, but tilted to one side.

This is referred to as a canting or occlusal plane inclination in orthodontic diagnosis.

The tilt of the teeth is not usually noticeable, but it can be prominent when taking a front-facing photo or smiling widely.

In such cases, simply closing the spaces between the teeth and moving the front teeth back may reduce the protrusion, but the asymmetry visible when smiling may still remain.

Therefore, in this treatment, we not only moved the front teeth back but also adjusted the vertical position of the teeth on both sides.

However, if there is a skeletal asymmetry, it is necessary to distinguish between the range that can be adjusted with orthodontic treatment and the range that requires skeletal treatment.

Not all asymmetries can be resolved with orthodontic treatment alone, so it is essential to explain the realistic range of improvement through a thorough examination before treatment.

We also examined the narrow V-shaped dental arch

Before treatment, the upper dental arch had a V-shaped form with a narrow width and a pointed front.

While a normal dental arch does not have to have the same shape,

if the dental arch is too narrow and crowded in the front, it can lead to protrusion of the front teeth, lack of space, dental asymmetry, and unstable occlusion.

Therefore, we considered the overall width and shape of the dental arch to ensure that the teeth could be arranged in a more harmonious way.

After the treatment was completed, the upper dental arch, which had been pointed and narrow, now had a smoother U-shaped form, and the teeth on both sides were more symmetrically arranged.

This is different from the concept of simply making the dental arch wider.

The key is to form an appropriate dental arch shape for the patient while considering the range of the teeth and gums.

We also considered changes in the lips when moving the front teeth back

In this patient, the upper front teeth had a forward inclination, so we moved the upper front teeth back during treatment.

However, simply moving the front teeth back is not enough.

If the angle and position of the tooth root are not adjusted together, the front teeth may become too inclined inward, affecting the stability and aesthetics of the teeth and lips after treatment.

While adjusting the angle and movement of the upper front teeth, we also examined the changes in the upper lip and nasolabial angle, lip closure, and front and side profiles.

After treatment, the protrusion of the upper lip decreased naturally as the upper front teeth moved back.

Changes After Treatment

The previously protruding upper front teeth moved back, reducing the horizontal gap and upper lip protrusion. The height and occlusal relationship of the left and right teeth were adjusted, and the narrow V-shaped upper dental arch was transformed into a more symmetrical U-shape, resulting in a stable change.

The key to this treatment was not just pushing the front teeth back, but also diagnosing and improving the Class II malocclusion, narrow dental arch, and vertical asymmetry to comprehensively enhance the balance of the teeth and face.

In Conclusion

The cause of a protruding mouth is not just the angle of the front teeth.

A narrow dental arch, height difference between left and right teeth, or skeletal asymmetry of the upper and lower jaws can also have an impact.

Therefore, if you are considering orthodontic treatment, please check if the clinic provides a comprehensive diagnosis of the cause of the protrusion, tooth inclination, dental arch shape, and changes in the lips after treatment.

Also, if your teeth appear to be tilted to one side or you are concerned about the protrusion of your upper front teeth and lips, please first confirm your current condition and the possible range of treatment.

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I hope today's story has been helpful to those who have been struggling with a protruding mouth and dental asymmetry, and I will conclude here.

• Dr. Soo-min Son -

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NAutomatically translated from the Korean post on our Naver blog. Read the original ↗