PMC7790564_01
The genealogy of the presenting patient.
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Parents have no consanguineous marriage (Figure 1).
Facial image of the patient.
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On extraoral examination, he was noticed to have fine sparse hair, scanty eyelashes and eyebrows, protruding lips with reduced lower facial height, periorbital pigmentation, and protruding low set of ears (Figure 2).
Preoperative intraoral images of (a) right buccal, (b) closed mouth, (c) left buccal, (d) lower arch, and (e) upper arch views.
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The lower permanent incisors (32 and 42) were conical in shape (Figure 3). With mild attrited facets on 85, the occlusal surface showed slight mobility. 65 and 75 had been extracted due to caries, and 37 was erupting (Figures 3).
Preoperative photoimage of dental panoramic tomograph.
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There were anterior conical teeth and overretained 81 with resorbing root and taurodontic molar teeth (Figure 4).
Intraoral photograph shows cemented crown and molar bands.
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The molar bands were cemented to all first molars (Figure 5).
Lower arch "Kesling diagnostic setup."
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Before commencing the second half of the orthodontic treatment, the lower arch "Kesling diagnostic setup" was made (Figure 6).
Intraoral photograph showing cemented palatal button on rotated 13 and 24.
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At the next visit, palatal buttons were fixed on rotated 13 and 24 in order to derotate (Figure 7).
Intraoral photograph showing immediately after extraction of 81.
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The overretained 81 was extracted prior to bond up of the lower arch (Figure 8).
Intraoral photographs of 25 (a) before and (b) after surgical exposure.
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In parallel to the orthodontic treatment, surgical exposure of 25 and distalization of 26 with a coiled spring was done to facilitate the eruption of 25 (Figure 9).
The "near-end radiograph" (digital dental panoramic tomograph).
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Prior to debonding the fixed applications, a "near-end radiograph" was taken to observe the status of root resorption, teeth position, and the available spaces and root parallelism for future implant placement of the overretained teeth (Figure 10).
All conical incisors were recontoured with LCC.
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Immediately after debonding, all the conical incisors and canines were recontoured using composites (Figure 11).
RBB was cemented to replace missing lower central incisors.
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The missing 41 was replaced by a cantilever RBB (Figure 12).
Comparison of preoperative and postoperative aesthetic outcomes.
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The total care rehabilitation, including aesthetic and preventive measures, seemed to be alright in our patient at the end of the 5-year follow-up period (Figure 13).