A Multidisciplinary Case: ​Creating an esthetic smile and ​closing missing teeth spaces with the minimal number of implants​

This 38-year-old female patient was referred to the orthodontic clinic by her student dentist to see what the orthodontic options are for resolving her crowding and potentially closing some of the missing teeth spaces. Pt presented with missing #4, 5, 12, 19, 30. She had moderate to severe anterior crowding in the maxillary arch and mild crowding in the lower arch. She presented with a Cl I canine relationship on the right and a full cusp Cl II canine relationship on the left. ​

The ideal treatment plan for her would be to close the #5 and #12 spaces by retracting the canines back, which would create space for her palatally blocked out laterals. On the lower arch, the plan was to upright the lower second molars and protract both the second and third molars forward to finish with a full cusp Cl II molar relationship bilaterally. This ideal treatment plan was achieved with good anchorage control using lower temporary anchorage devices (TADs), which were placed in her alveolar bone and then removed at the end of treatment. ​

The total treatment time was 2.5 years, which is relatively efficient considering that we uprighted and protracted 2 lower molars bilaterally in addition to closing two upper premolar spaces. This case is also significant because it allowed the patient to get the minimum number of implants necessary; not only is this good from a financial standpoint but it is also easier for her to maintain in terms of oral health.

Author(s): Dr. Bianca Amy Lau, Ortho ’22, Youjia Maggie Ma, DDS ’22, Janice Ma, DDS ’23
Mentor(s): Dr. Joorok Park, Dr. Ivan Lo, Dr. Micaela Zaverdinos, Youjia Maggie Ma, Janice Ma, Dr. Gonzalez, Dr. Noble

Residents Orthodontics Award

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