A Case of Extraction Orthodontics for Protruding Lips That Improved a Gummy Smile, Lip Incompetence, and More | See the Changes in the Buccal Corridors Too

Hello.

This is Yonsei Baro Dental Clinic, a Gangnam orthodontic clinic.

Today, I would like to introduce a case of extraction orthodontic treatment that improved not only protruding lips and the alignment of the front teeth, but also a gummy smile, lip incompetence, and the overall shape of the smile.

When people hear “orthodontic treatment for protruding lips,” they often think of it simply as “treatment to move protruding front teeth backward.”

However, orthodontic treatment is not just about changing the position of the front teeth.

To achieve a more satisfactory result, it is necessary to consider the degree of protrusion of the front teeth, the bite between the upper and lower teeth, the prominence and closure of the lips, the amount of gum displayed when smiling, and the shape of the smile created by the teeth and gums.

In this case as well, the treatment plan was designed not only to improve the protruding lips, but also to consider the gummy smile, lip incompetence, and three-dimensional changes in the smile.

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For today’s post, it may be helpful to focus on the gummy smile, where a significant amount of gum is visible, and the changes in the buccal corridors.

I will explain how a gummy smile and buccal corridors affect smile aesthetics.

This patient visited us in June 2023 to improve lip protrusion and tooth alignment.

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A midline discrepancy can be seen.

There is a large gap between the upper and lower teeth because of the protrusion of the upper front teeth.

When the bite of the front teeth is in this condition, the lips cannot close comfortably.

This can cause lip incompetence.

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Because the front teeth were considerably protruded, a treatment plan involving extraction orthodontics with removal of the two upper premolars was established.

Based on the patient’s initial facial appearance, it was anticipated that moving the lower lip significantly backward would not be desirable. Therefore, the plan for the lower arch involved removing the impacted wisdom teeth and placing miniscrews to move the teeth slightly backward, without extracting the lower premolars.

The patient chose Clippy-C orthodontic treatment.

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Treatment progressed after placing miniscrews.

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At this point, approximately half of the extraction space remained.

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Orthodontic treatment continued for 1 year and 8 months and was completed in January 2025.

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The midlines now coincide,

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and the molar bite is also good.

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This is how the teeth look with all retainers in place.

Let’s look at the before-and-after comparison photos.

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Improvement in the midline and deep bite

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Treatment was performed with the goal of achieving a tight bite.

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As the protrusion of the front teeth was relieved, the gap between the upper and lower teeth became smaller.

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When the upper front teeth are significantly protruded, the lower lip can become positioned between the upper and lower teeth, causing the upper teeth to remain slightly visible between the lips when they are closed.

As the protrusion of the upper teeth was relieved, the lips that previously could not close now close comfortably.

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Lip incompetence was resolved.

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Although this was extraction orthodontic treatment, the volume of the lips was well maintained.

If the lower premolars had also been extracted, the lower lip might have appeared excessively retruded.

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The formation of buccal corridors also changed the impression of the smile.

One particularly interesting aspect of this case is the change in the buccal corridors.

Buccal corridors are the dark spaces visible between the upper molars and the inside of the cheeks when smiling. They are one of the elements that create three-dimensionality in a smile, in contrast to a smile in which the teeth appear densely packed together.

Before treatment, the teeth and gums appeared to fill the entire smile space.

After treatment, however, the smile changed from one in which only the teeth and gums appeared tightly packed to a more compact and neat smile, with appropriately formed buccal corridors.

As this case demonstrates, smile aesthetics are not determined solely by the color or alignment of the teeth.

The harmony of

teeth + gums + lips + buccal corridors

must also be considered together.

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The prominence of the front teeth was relieved.

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Extraction orthodontics for protruding lips: concerned about changes in the appearance of your lips?

Even when considering extraction orthodontic treatment because of significantly protruding lips, some people have concerns such as:

“Will my mouth move too far backward if I have teeth extracted?”

“Will my lower lip look too sunken?”

“Will more gum show when I smile?”

However, extraction orthodontics is not a treatment in which all the teeth are moved backward by the same amount. The amount of movement is planned by comprehensively considering the patient’s skeletal structure, the degree of tooth protrusion, the position and volume of the lips, and the bite.

As in this case, the upper arch can be treated with extraction orthodontics to sufficiently improve protrusion, while the lower arch can be treated without extraction by using miniscrews to move the teeth only as much as necessary.

In addition, if aesthetic elements such as a gummy smile, gum display, lip incompetence, the smile line, and buccal corridors are considered together during treatment for protruding lips, a more harmonious result may be achieved.

If you are concerned about showing a significant amount of gum when smiling or about your front teeth appearing to protrude like rabbit teeth along with protruding lips, it may be helpful to have your entire lip profile and smile evaluated rather than looking only at tooth alignment.