Evaluating Changes in Smile Components After Intrusion of Maxillary Anterior Using Fixed Mechanotherapy with Mini Implants: A Photographic Study

Introduction: The 21st century redefined soft-tissue aesthetics, highlighting the smile’s role in facial attractiveness. Smile analysis evaluates the lips, gums, and teeth, focusing on eight key elements. Gingival visibility, determined by the smile line, defines a gummy smile, classified into three types by Mercado-Rosso based on anatomical and muscular factors. Materials and Methods: The research included 10 participants aged 18 and older who met the study’s inclusion criteria. Smiling photographs were taken before orthodontic mini-screw placement (T0) and after 4 months of intrusion (T1). These photographs were analysed for three smile parameters: horizontal, vertical and dichotomous variables, using the MAKHTER software to assess changes. For the analysis, descriptive statistics were used to calculate the mean and standard deviation for continuous data, while a paired t -test was employed to compare pre- and post-intrusion results. In addition, the Wilcoxon signed-rank test was used for categorical data, with significance set at P < 0.05. Significant changes were observed in key smile features such as outer commissure width, posterior maxillary dentition visibility, philtrum height, upper lip thickness, upper incisal visibility and gingival display. Results: The findings demonstrated that mini implants used for upper anterior intrusion were effective in altering both vertical and horizontal smile characteristics. The most notable impact was on the vertical smile components, which resulted in a reduction of gummy smiles and an overall improvement in the aesthetics of the smile. Conclusion: This study highlights the potential of orthodontic intrusion using mini screws to enhance smile appearance by adjusting soft-tissue parameters.