Buccal corridor and gummy smile treatment with MARPE and gingivoplasty: A 2-year follow-up case report

Abstract

The advent of Mini-screws assisted rapid palatal expansion (MARPE) has introduced a simpler in-office procedure that enables the translation of the alveolar process in adults. This case report showed the combination of MARPE, orthodontic treatment, and gingivoplasty to correct malocclusion and enhance smile aesthetics. A 20-year-old woman expressed concerns about excessive buccal corridors and a gummy smile. She exhibited skeletal class I malocclusion, with buccal corridors exceeding 4 mm, a gummy smile, and lingual tipping of the lower posterior segments. The treatment plan involved utilizing the MARPE appliance, a Nitinol wire, gingivoplasty to address the gummy smile. Retention evaluations demonstrated the stability of MARPE in transversal skeletal discrepancies. There was notable improvement in incisor inclination and soft tissue profile, particularly evident in the E-line and nasolabial angle. Cephalometric analysis confirmed these changes, showing a decrease of 5.9 degrees in the inclination of the maxillary incisors. After a 2-year follow-up, the results remain stable, and the patient expresses satisfaction with the outcome. MARPE can be considered as an effective tool for managing buccal corridors, complemented by fixed orthodontic treatment employing labial appliances and gingivoplasty to correct malocclusion and enhance smile aesthetics. The treatment showed positive long-term outcomes.