PMC5573452_01
Pretreatment facial and intraoral photographs.
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a) Pretreatment panoramic radiograph, b) Panoramic radiograph with alveolar distractor, c) Lateral cephaometric radiograph showing alveolar distractor.
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Eventually the patient lost first and second left mandibular molars, resulting with a large alveolar bone defect (Figure 2a). She was presented a treatment plan that consisted of alveolar distraction of left premolars posteriorly until third molar to increase the alveolar bone height prior to implant placement, orthodontic intrusion of overeruped upper teeth and finally prosthetic implant replacement of the missing teeth (Figure 2b, 2c).  However, distraction protocol was unsuccessful and the premolar teeth lost vitality.