PMC4751301_01
Facial photographs obtained before treatment.
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F1
The initial facial examination revealed a Class III skeletal pattern with moderate maxillary deficiency (Figure 1).
Pretreatment photographs. A-E, Intraoral photographs obtained before treatment; F-J, pretreatment dental casts.
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F2
Moreover, prosthetic abutments and the cervical portions of the implants were exposed to the oral environment (Figure 2).
Pretreatment panoramic, periapical, and lateral cephalometric radiographs.
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F3
Panoramic (Figure 3A) and periapical radiographs (Figure 3B-E) showed advanced vertical bone resorption in the implant region, with the first 3 threads exposed on the left implant. An analysis of lateral cephalometric radiography confirmed an increased maxillomandibular discrepancy with marked compensation of the anterior teeth and increased labial angulation of the implants (Figure 3F).
Final photographs after orthodontic appliance removal. A-C, Facial photographs; D-H, intraoral photographs.
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F12
The patient underwent esthetic procedures to correct dental discrepancies i.e., reshaping of the canines into lateral incisors and the premolars into canines that occurred as a consequence of the tooth migration process (Figure 12).
Facial photographs taken at the three-year follow-up.
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F13
At the three-year follow-up, facial and occlusal esthetic improvements were achieved with the proposed treatment and the results remained stable, meeting the functional and esthetic expectations of the patient (Figures 13 and 14).
The follow up after three years. A-E, Intraoral photographs taken three years post-treatment; F-J, final treatment dental casts.
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F14
At the three-year follow-up, facial and occlusal esthetic improvements were achieved with the proposed treatment and the results remained stable, meeting the functional and esthetic expectations of the patient (Figures 13 and 14).
The cephalometric superimposition. A, Pre-treatment (black line) and post-decompensation (blue line). B, Pretreatment (black line) and post-treatment (red line).
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F15
Furthermore, occlusal plane alterations have much greater effects in the anteroposterior region (incisal region) than in the symphysis region, as shown in the post-treatment cephalometric tracing (Figure 15) only on the right side of the mandible. Pre- and post-treatment cephalometric tracings (Figure 15) show maxilla advancement and minimal changes in mandibular position.