Case Type:
Class I Non-Extraction
Problem List:
Bimaxillary retrusive
Upper and lower dento-alveolar retrusion
Severe arch length discrepancy on the maxilla and moderate on the mandibular arch
Impacted upper left canine and both lower canines
Severe distal ectopia of lower laterals
Lack of attached gingiva on lower central incisors
Third molars are developing and unerupted
Growth is pre-pubertal
Case Resumé:
A young lady age 11y 1m; pre-pubertal. Maxillary midline is 2mm to the left. The overjet is 1mm to 1.5mm and the overbite is 5mm due to the lingual inclination of the upper and lower incisors and the over-eruption of the lowers. There are a total of 3 impacted canines, one in the maxillary arch, and 2 in the mandibular. In the mandibular arch, we can see severe distal ectopia of both laterals with mesial rotation of approximately 90°. Mandibular crowding is estimated at 4 mm, with severe distal displacement of the lower incisors. There is a cyst around the crowns of the lower impacted canines and a risk of root resorption of the lateral.
Treatment Plan
Maxillary arch:
Alignment
Create space for the canine
Dental anchorage preparation
Orthodontic traction for the upper left canine
Archform coordination
Retention
Mandibular arch:
Gingival graft on the lower central incisors
Lower arch alignment excluding the lower lateral incisors
Dental anchorage preparation
Correction of the lower lateral ectopia with an auxiliary arch
Orthodontic traction for the lower canines
Archform coordination
Retention
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