Vertical Control Revisited in Extreme Hyperdivergent & Hypodivergent Patients

Vertical control is essential for achieving a balanced lower facial profile after orthodontic treatment. Rather than relying on passive vertical control, active vertical control is recommended for patients with extreme hyperdivergent and hypodivergent conditions. In hyperdivergent cases, skeletal anchorage facilitates total arch intrusion, which helps correct a gummy smile, promotes forward mandibular rotation, and enhances chin projection. For hypodivergent patients, extractions are typically avoided, and total arch extrusion is advised to increase maxillary incisor display. The interactions between various factors that influence occlusal plane control will be explored, with protocols for both total arch intrusion and extrusion demonstrated. With the support of skeletal anchorage, controlling the occlusal plane may significantly improve treatment outcomes for patients with vertical discrepancies.