الفهرس 
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Abstract
This randomized clinical trial was conducted to assess the correction of excessive gingival display in VME patients using two different techniques. Patients with VME were treated with total maxillary arch intrusion using either fixed orthodontic appliances or thermoplastic splints, in conjunction with four miniscrews for anchorage.
Twenty adult patients with more than 4 mm gummy smile were recruited for this study from the outpatient clinic of the Orthodontic Department, Faculty of Dentistry, Ain Shams University. The sample was equally divided into two groups. group I was treated with fixed orthodontic appliances, while group II were treated with a thermoplastic splint. Four miniscrews were inserted in each patient, two anterior screws between the maxillary lateral incisors and the maxillary canines bilaterally, and two posterior miniscrews between the maxillary first permanent molars and the maxillary first premolars bilaterally. An intrusive force was applied on each screw with the purpose of total maxillary arch intrusion. Only sixteen patients completed the study with four dropouts, two in each group.
Treatment results were assessed using standardized digital photographs, CBCT scans, and lateral cephalometric radiographs generated from the CBCT scans. The records were acquired at T0 “before intrusion” and T1 “after intrusion”. The standardized digital photographs were used to assess the effect of treatment on the amount of gingival display. The CBCT scans and the lateral cephalometric radiographs were used to assess the dental and skeletal effects of treatment in all planes of space and the amount of root resorption.
Both groups showed a statistically significant reduction in the amount of gingival display anteriorly and posteriorly. The reduction of gingival display was significantly higher in the fixed appliance group. The amount of gingival display was corrected to the acceptable range “less than 2 mm of gingival display” using fixed appliances.
There was a statistically significant intrusion at the central incisors, canines, and first permanent molars in both groups indicating that total maxillary arch intrusion was successful. The amount of intrusion was more in the anterior region compared to the posterior region. Comparing between the two groups, greater amounts of intrusion were achieved in the fixed appliance group and the difference was statistically significantly.
The fixed appliance group also showed a statistically significant reduction in the mandibular plane angle and the lower anterior facial height indicating counterclockwise mandibular autorotation.
All the measured teeth showed significant amounts of root resorption, the amount of resorption was more in the fixed appliance group compared to the thermoplastic splint group.