PMC9507020_01
Pretreatment facial and intraoral photographs.
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The patient had vertical facial pattern with a convex profile, absence of passive lip sealing and an asymmetric smile, with minimal exposure of maxillary teeth, and evidence of anterior projection of the tongue at rest and during swallowing (Fig 1). Occlusal analysis revealed a Class II molar relationship, with anterior and posterior open bite, reduced overjet, significant shift of the upper midline to the left side, and maxillary transverse deficiency (Fig 1).
Pretreatment panoramic radiograph.
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The maxillary left central incisor presented severe displacement, with an angulation greater than 90o in relation to the sagittal plane (Fig 2).
Pretreatment tomographic images.
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The maxillary left canine root was in close relationship with the maxillary sinus (Fig 3).
Pretreatment lateral cephalometric radiograph.
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The maxillary and mandibular central incisors were lingually tipped (U1.NA = 18 , U1-NA = 2mm, L1.NB = 19 , L1-NB = 4mm, IMPA = 83.5 ) (Fig 4).