Torque Controlled True Intrusion and Retraction: A Novel Protocol for Altering the ‘Gull-Wing Lip’ Morphology:

Abstract

The paradigm of orthodontics in the past century has been limited to the dentoalveolar segment and to some extent the jaws. The shift from hard tissue paradigm to soft-tissue has wide ned our focus on how we look at the face as a whole. Brin ging about changes in soft-tissue contours, once thought to be beyond the scope of orthodontics are now being addressed to. Once such example of atypical soft-tissue morphology is the ‘gull-wing’ lip pattern. This pattern is identified by an obvious increase in incisal exposure at rest and smile and an excessive difference between the philtrum and commissural length. The lip morphology is known to be dependent on the vestibular sulcular depth which in turn depends on the vertical anterior teeth root positioning. The vertical incisal show is merely a manifestation of improper sulcular morphology seen in the gull-wing lip pattern. The true intrusion of maxillary incisors and simultaneous torque controlled retraction tends to alter the sulcular morphology and in turn the gull-wing pattern.