There are clear clinical limits which have to be observed when moving upper incisors mesially. Problems can develop in seemingly easy treatments, and the risks lie in two areas:
1. Excessive proclination. It is necessary to avoid excessive proclination of the upper incisors, otherwise unesthetic appearance and inadequate function will result. As a general rule, proclination of the upper incisors beyond 120° to the maxillary plane should be avoided, although there is individual variation (Fig. 8.20). In some cases, less proclination than 120° may be appropriate. Gingival recession and long clinical crowns can result from excessive proclination.
2. Failure to fully achieve a positive overjet. This can be due to the forward position of the lower incisors, or other reasons, and the resulting bite can be difficult to manage (Fig. 8.21). If this is allowed to persist, then there is a risk of enamel damage and/or root resorption. Accordingly, it is unwise to attempt to correct a Class 111 incisor relationship by orthodontic procedures alone, unless it is clear from the outset that full correction can be achieved, and a near normal overjet obtained.
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