Orthodontic Treatment With Deep Overbite In A Short-Faced Female

This case report shows a five-year observation of orthodontic treatment involving extraction in an adult female with a short face, deep anterior overbite and periodontitis, with the expectation of providing some new thoughts for similar cases. An adult female patient complained of lip protrusion, similar to her father's facial profile. The patient presented with periodontitis, Angle Class II Division 1 malocclusion, crowding, a short-face, deep overbite and deep overjet. Our treatment plan involved extracting four first premolars to align the teeth, closing the extraction space with maximum maxillary anchorage and moderate mandibular anchorage. After 23 months of treatment, the patient achieved stable occlusion and an aesthetic profile, with several gingival black triangles having disappeared. The treatment principle for this patient involves root-controlled retraction of the anterior teeth and extrusion of the posterior teeth, resulting in a clockwise rotation of the occlusal plane. The use of double keyhole loops can effectively manage the vertical height of the upper anterior teeth, thereby preventing the deepening of the overbite due to the "pendulum effect". Extensive alveolar bone remodeling and improved gingival black triangles were observed in the upper anterior region after treatment, which correlated with the alignment of the teeth, the correction of deep overbite and excellent plaque control in the patient. For patients with periodontitis and a deep overbite of the anterior teeth, standardized orthodontic treatment can eliminate adverse traumatic stimuli, which facilitates the remodeling of periodontal tissues.