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AS17B03C - Maximum Facial Profile Changes in Hyperdivergent Patients

‐ Apr 22, 2017 8:00am

The treatment of patients with hyper-divergent skeletal patterns have been considered as one of the most difficult task for orthodontists. With traditional mechanics, it was almost impossible to reduce vertical dimension during orthodontic treatment. Occlusal correction can be obtained but there was deterioration of facial harmony. The microimplants have brought tremendous paradigm shift in orthodontic treatment. Among those, the advances in vertical control are of a paramount importance. Nowadays, the intrusion of the posterior teeth with/or without anterior teeth can be achieved easily and consistently with microimplants. In openbite treatment, the intrusion of the posterior teeth is known as best treatment strategy. The intrusion of the posterior teeth can produce the increase of the anterior overbite, and resulted in resolution of the anterior openbite. However, even though intrusion of the posterior teeth is obtained and anterior openbite is closed, the profile improvement is less than desirable occasionally in Hyperdivergent patients. In order to get better profile changes, vertical control should be done not only in the posterior teeth but also in the anterior teeth. And this should be done on both arches, not to one arch. In hyper-divergent patients, the extraction of premolars can be planned and this will be helpful in reducing vertical dimension. However the facial changes can be very different according to which teeth are extracted. Occasionally, extraction of teeth may results in dished in face with counterclockwise rotation of the mandible. The cant of occlusal plane in antero-posterior dimension can also affect on facial harmony. Speaker will discuss the importance of extraction sites, and its role in controlling the occlusal plane, and importance of intrusion of the whole arch in regard to facial harmony.

Learning Objectives:

  • Discuss importance of vertical control in facial profile changes.
  • Demonstrate factors to get maximum changes of the face in hyperdivergent patients.
  • Explain biomechanics concerning the microimplant treatment.


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