PMC9681562_01
The patient's facial and intraoral photographs taken before treatment at the age of 12 years and one month.
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The maxillary incisors and canines showed some enamel erosion (Figure 1).
(a) Cephalometric radiograph (b) and cephalometric tracing before treatment.
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Panoramic radiograph before treatment.
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Table 1). The panoramic radiograph revealed four developing third molars (Figure 3).
The patient's intraoral photographs taken after 8 months of orthodontic treatment.
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Thereafter, removable plate wear was discontinued, and the maxillary dental arch was aligned within 4 months with the same type of fixed appliances as in the mandibular dental arch (Figure 4).
PMC9681562_02
Intraoral pictures taken by the patient shortly after emergency dental treatment.
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After that, the patient had taken intraoral photographs of the displaced teeth with his smartphone (Figure 5).
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PMC9681562_04
Photograph of the deformed 0.016'' x 0.022'' SS wire from the mandibular dental arch after dental trauma. The impact of the trauma had detached the brackets from the mandibular right central and lateral incisors and the mandibular left central incisor.
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The SS wire in the mandibular dental arch (Figure 6) and the still partially present SS wire in the maxillary dental arch were removed.
Dental CBCT images of the luxated teeth in the maxilla and mandible. Sagittal sections through the (a) maxillary right canine, (b) maxillary right lateral incisor, (c) maxillary right central incisor, (d) maxillary left central incisor, (e) mandibular right canine, (f) mandibular right lateral incisor, (g) mandibular right central incisor, and (h) mandibular left central incisor are shown. The red arrows indicate the location of a buccal alveolar socket wall fracture. The yellow arrows indicate the regions with an enlarged periodontal ligament space.
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Furthermore, an enlarged periodontal ligament space was found at the apex of all extruded teeth (Figure 7).
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PMC9681562_06
The patient's intraoral photographs taken directly after starting leveling and alignment with the 0.012'' Ni-Ti round wires, one day after the dental trauma.
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Then, starting with light orthodontic forces in both dental arches, 0.012'' Ni-Ti round wires were placed (Figure 8).
PMC9681562_07
The patient's intraoral photographs taken after 3 weeks of leveling and alignment with the 0.012'' Ni-Ti round wires.
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The occlusal stops on the maxillary first molars were then removed (Figure 9).
The patient's intraoral photographs taken during orthodontic finishing with 0.016'' x 0.022'' SS wires.
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A 0.016'' x 0.022'' SS wire was placed in both dental arches, and then Class II elastic traction (3.5 oz, 1/4'') was started to achieve optimal sagittal relationship between the front teeth (Figure 10).
Periapical radiographs of the endodontic treatment of the (a) maxillary right central and lateral incisors, (b) maxillary left central incisor, and (c) maxillary right canine. The periapical radiographs (left) before endodontic treatment, (middle) during root canal working length measurement, and (right) after endodontic preparation and root canal and filling.
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PMC9681562_08
The patient's facial and intraoral photographs taken after treatment at the age of 13 years and ten months.
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At the day of debonding, facial and intraoral photographs (Figure 12), cephalometric radiograph (Figure 13(a)), and panoramic radiograph (Figure 14) were taken after removal of the orthodontic appliances.
(a)Cephalometric radiograph and (b) cephalometric tracing after treatment.
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At the day of debonding, facial and intraoral photographs (Figure 12), cephalometric radiograph (Figure 13(a)), and panoramic radiograph (Figure 14) were taken after removal of the orthodontic appliances.
Panoramic radiograph after treatment.
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At the day of debonding, facial and intraoral photographs (Figure 12), cephalometric radiograph (Figure 13(a)), and panoramic radiograph (Figure 14) were taken after removal of the orthodontic appliances. Table 1). The endodontically treated maxillary right central and lateral incisors, canine, and maxillary left central incisor demonstrated no further pathology or complaints (Figure 14).
Cephalometric tracings before (black lines) and after treatment (red lines) were superimposed using Bjork and Skieller's structural method. (a) General superimposition of the cephalometric tracings before and after treatment on the anterior cranial base. (b) Superimposition of the maxillary tracings before and after treatment on the anterior contour of the zygomatic process. (c) Superimposition of the mandibular tracings before and after treatment on the stable structures in the mandible.
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The hypodivergent skeletal pattern was maintained (Figure 15(a)). The superimposition of the maxillary tracings before and after treatment on the anterior contour of the zygomatic process showed a mesial displacement with a slight mesial tip of the first maxillary molars and a retroclination and slight extrusion of the maxillary incisors (Figure 15(b)). The superimposition of the mandibular tracings before and after treatment on the stable structures of the mandible (the protuberantia mentalis, the inner contour of the lower cortical plate of the symphysis, and the contours of the alveolar canals) demonstrated condylar growth and mandibular remodeling, along with extrusion and mesial displacement of the mandibular first molar and intrusion and retroclination of the mandibular incisors (Figure 15(c)).
PMC9681562_09