PMC6425302_01
Pretreatment intraoral and maxillary dental cast photographs.
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Dental analysis showed an Angle Class I malocclusion, normal overjet, a moderate overbite, and a slightly maxillary midline, shifted to the right (a posterior crossbite on the right side involved the first molar and both bicuspids (Figure 1(a)). Gingival retraction and dental abrasion in the facial cervical region were localized in the cervical areas of the maxillary canines and incisors (Figure 1(b)). There was wear on the occlusal and tip of the canines, premolars, and molars (Figures 1(a), 1(e), 1(f), 2(a), and 2(b)) and severely worn facets on the palatal surface of the maxillary canines and incisors, due to probable strong contact with the tip of the mandibular incisors (Figure 2(b)). The panoramic radiograph showed no significant root resorption (Figure 6(a)). The transverse dimension was changed slightly after treatment, where the intermolar width was slightly changed from 37.0 mm (Figure 1(d)) to 41.0 mm (Figure 5(d)).
Pretreatment dental casts showing abrasions and posterior crossbite.
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There was wear on the occlusal and tip of the canines, premolars, and molars (Figures 1(a), 1(e), 1(f), 2(a), and 2(b)) and severely worn facets on the palatal surface of the maxillary canines and incisors, due to probable strong contact with the tip of the mandibular incisors (Figure 2(b)).
Pretreatment cephalometric and panoramic radiograph.
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The panoramic radiograph showed extensive restorations on the maxillary and mandibular molars (Figure 3(a)).
Progress details. Restoration of the palatal surface.
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On the left side, an extension was established on the second premolar and the second molar to increase the anchorage (Figures 4(a) and 4(b)). A 0.016 in SS archwire, with a mesially bent helicoidal loop, was used to jump both premolars, buccally (Figures 4(e) and 4(f)). After removing the mini-expandex, vertical crossbite elastics were attached to the archwire (Figure 4(c)).
Posttreatment intraoral and maxillary dental cast photographs.
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Amelogen (Ultradent) color A2, and Durafill (Heraeus/Kulzer) color A2. After 14 days, the finishing and polishing of the composite resin restorations were carried out, achieving an excellent aesthetic result with this restorative technique (Figure 5). The buccal cuspids of the maxillary right molar and premolars were built-up with composite resins (Figure 5). The panoramic radiograph showed no significant root resorption (Figure 6(a)). The transverse dimension was changed slightly after treatment, where the intermolar width was slightly changed from 37.0 mm (Figure 1(d)) to 41.0 mm (Figure 5(d)).
Posttreatment cephalometric and panoramic radiograph.
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The panoramic radiograph showed no significant root resorption (Figure 6(a)). The transverse dimension was changed slightly after treatment, where the intermolar width was slightly changed from 37.0 mm (Figure 1(d)) to 41.0 mm (Figure 5(d)).
Follow-up intraoral photographs at 37 months.
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The patient stopped using the retainer one year after debonding (Figure 7).