Esthetic Considerations of Bimaxillary Protrusion Treatment Using Periodontic-Orthodontic Interdisciplinary Approach: A Case Report

Bimaxillary protrusion is a frequently observed anomalies among Asian. The condition is marked by proclined upper and lower incisors, and typically associated with a gummy smile. Facial aesthetics is the primary concern of these patients. Effective treatment relies on a comprehensive assessment and comprehension of this dentofacial malformation. Crown lengthening, a surgical procedure, effectively corrects excessive gingival display. This case report underscores the importance of a collaborative periodontic-orthodontic approach in treating bimaxillary protrusion. A 19-year-old female presented with Class I malocclusion, bimaxillary prognathism, maxillary anterior crowding, and excessive gingival display. Her profile was convex, with Class II skeletal relationships. Examination revealed a proclined incisors with +2.39 mm overjet and +1.87 mm overbite, tooth 63 persistence, and more than 2 mm of excessive anterior gingival display. Treatment involved a fixed orthodontic appliance with MBT technique. Prior to bracket placement, the persistent tooth 63 was extracted. After 18 months of treatment, malocclusion and tooth misalignment were successfully addressed. In this case, where the biological width is less than 2.0 mm in the region of teeth 15-25, crown lengthening with osteoreduction is performed to correct the condition and achieve an ideal biological width. Interdisciplinary collaboration between orthodontists and periodontists was essential in this situation. The crown lengthening after orthodontic treatment enhanced tooth proportions and smile cosmetics, facilitating balanced occlusal function. This comprehensive strategy guarantees thorough oversight of both practical and aesthetic elements. The patient expressed high satisfaction with the results, as the gingival tissues were healthy and h ad a normal contour.