Orthodontic Correction for Protrusive Mouth in Your 30s :: Gum Smile Correction, Gummy Smile Correction, Lip Incompetence, Missing Teeth, and Chin Correction

Hello,

This is Apgujeong Orthodontic Clinic.

There are broadly two types of orthodontic treatment that can dramatically change your appearance.

The first, above all else, is protrusive mouth correction.

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The second is gummy smile correction.

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If this is combined with intrusion of the entire maxillary dentition and even causes autorotation of the lower jaw, orthodontic treatment alone can produce results as dramatic as double-jaw surgery.

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This patient came for orthodontic treatment two years ago.

There were three things they wanted to improve:

Spacing

Asymmetry

Chin deficiency

There was a skeletal asymmetry with the lower jaw twisted to the left, and the midline of the front teeth was also off.

The blue arrow indicates a peg lateral.

After orthodontic treatment, veneer restoration will be needed.

An open bite is visible, where the upper front teeth do not cover the lower front teeth.

Looking at the occlusal surface, you can see that one large molar at the back on the inside is missing.

It is a congenitally missing tooth.

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A noticeable gummy smile is seen when smiling.

There is also lip incompetence, where the lips do not close comfortably because of protrusion, and the resulting chin dimpling (mentalis strain).

In fact, when skeletal analysis is done, the chin deficiency is not severe, but the chin-tip overstrain caused by protrusive mouth, that is, chin dimpling, is a major cause of making even a normal chin look deficient.

For active reduction of the protrusion, extraction of four premolars would be needed.

However, on the side where a molar is missing, we decided to balance things with posterior movement without extracting a premolar.

The patient chose Clippy-C orthodontics, and treatment began after extracting three premolars.

These are photos from one year after treatment began.

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We proceed with closure of extraction spaces, retraction of the front teeth, relief of the gummy smile, and intrusion of the entire dentition to improve lower facial height and resolve the chin deficiency.

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Finally, in July 2025, the two-year orthodontic treatment is completed.

Now it is time to remove the Clippy-C brackets and proceed with gum contouring and veneer treatment for the peg lateral.

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This is immediately after gum contouring.

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After the gum contouring recovery period, this is the state just before veneer placement.

This is after no-prep veneers were placed on the peg lateral.

Which side is the natural tooth, and which side is the peg lateral veneer?

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The answer is that the tooth indicated by the blue arrow is the Jelami.

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The molar occlusion is perfectly tight and stable.

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A fixed wire retainer has also been placed.

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The midline that had been shifted due to asymmetry has been corrected.

Orthodontics alone cannot change jawbone asymmetry, but it can at least align the dental midline accurately.

In the post-treatment photos, you can see that the front tooth bite is somewhat deep, right?

This was intentional. If the front bite is shallow at the initial exam, it is better to finish with a slightly deeper bite than normal, considering relapse.

The concept of overcorrection, or finishing with some allowance for relapse after orthodontic treatment, is very important in treatment.

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The peg lateral was neatly restored with no-prep Jelami veneers.

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The molar relationship is Class I on both the left and right sides.

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These are before and after gum contouring immediately after orthodontic treatment.

Now let’s look at the facial changes.

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The chin asymmetry remains, but as the chin-tip tension was released, the jawline improved noticeably.

In particular, the shorter lower facial height stands out.

I will show the change in lower facial height again in the later X-ray superimposition.

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The beautiful tooth proportions and smile line stand out.

The front tooth midline, which had been deviated toward the peg lateral side, is now aligned with the nose and philtrum.

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A clear improvement in the gummy smile

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The natural and attractive lip line stands out.

The beautiful jawline, which had been unfairly associated with chin deficiency because the mouth could not close well due to protrusion and the chin dimples, has finally been revealed.

During the two-year orthodontic period, mild root resorption is seen in some of the front teeth.

Root parallelism is good.

It is confirmed that the upper front teeth moved back 4 mm relative to the starting position and moved up 2 mm to improve the gummy smile.

What should we pay attention to more than the changes in the front teeth?

The position of the lower jaw.

Due to intrusion of the entire maxillary dentition, autorotation occurred in which the lower jaw closed more, and the chin moved upward and forward by about 2 mm.

The lower face became shorter, and the chin actually came forward.

With the chin actually moving forward like this, and as muscle tension in the chin area was released through improvement of the protrusive mouth, the chin dimple disappeared, dramatically changing the lower jawline.