PMC6757353_01
Extraoral photograph of the patient showing (a) convex lateral facial profile and (b) frontal facial view where prominent nasal bone, narrow nose, indistinctive philtrum, and incompetent lips can be seen.
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On extraoral examination, the patient had a noticeable convex facial profile, poorly distinctive philtrum of the upper lip, prominent nasal bone, narrow nose, and obviously incompetent lips (Figure 1).
Intraoral photographs are showing (a) upper jaw with characteristic prominent median palatal suture, (b) lower jaw with lingually erupting #42 indicating crowding; (c) right side view is showing sinus tract related to #54; and (2d) left side view showing heavy calculus accumulation.
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Intraorally, the maxillary labial frenum was entirely absent, and the palate was narrow, high arched, and V-shaped with a prominent midpalatal suture (Figure 2(a)). No abnormality was detected with respect to the oral mucosa and gingival tissues, except for a small sinus tract related to the remaining root stumps of the maxillary right first primary molar (Figures 2(b)-2(d)).
Images show (a) an intraoral image showing the frontal view of SMMCI and (b) orthopantomography (OPG) showing SMMCI.
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It exhibited mirror image symmetry between its right and left sides, which mimicked the anatomic contour of the distal surface of a normal maxillary central incisor (Figure 3).
Images shows (a) lateral cephalogram and (b) cone beam computed tomography (CBCT) frontal view showing SMMCI.
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Both Anterior Nasal Spine (ANS) and Sella Nasion-Mandibular Plane (SNMP) angles showed a huge disparity from normal values, which reflected a highly prominent premaxilla (Figure 4(a)). However, nasal stenosis was observed on frontal cone beam computed tomography (Figure 4(b)).