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TAD – Transpalatal Arch-MOD Combination System: An Effective Tool in the Nonsurgical Management of Individuals with Vertical Facial Patterns and Gummy Smiles

The treatment of vertical facial patterns with gummy smiles in adults has long been a challenge to the orthodontist. Before the advent of microimplants, correction of such complex skeletal problems in adults was only possible with the help of orthognathic surgery. Orthognathic surgery in such situations aimed at LeFort I impaction of the maxillary dentoalveolar segment followed by counterclockwise rotation of the mandible, thereby improving the gummy smile and chin prominence. With the introduction of skeletal anchorage systems and microimplants in the last decade and the promising results that it has shown over the years, we as orthodontist now believe that surgery can definitely be avoided in selected cases when temporary anchorage devices are used – orthognathic surgery such as orthodontics. Microimplants have therefore expanded the envelope of discrepancy on which the orthodontist can work on. This case report focuses on the use of the TAD – Transpalatal arch-MOD combination system for nonsurgical management of adults with vertical facial pattern and gummy smile and details of the biomechanical perspectives associated with it.