I st class malocclusion with crowded teeth, ectopic canine, impacted lower premolar
2 years of fixed orthodontic treatment conventional braces
The patient aged 13, referred to me as she had esthetic problems because of the very crowded teeth. The analysis of the clinical records (dental casts, photos, Xray) showed no space for the alignment of all the teeth in the dental arch and the need to extract the upper first premolars in the upper arch, the second left lower premolar that was included in the bone with no space in the arch and the right 1st lower molar that was compromised (apical granuloma).
After 2 years of orthodontic treatment the patient was very happy about her smile, being more self-confident.
The patient aged 16, was referred to me by another colleague that started her fixed orthodontic treatment in the upper arch. She had the upper right lateral incisor missing (congenital missing/never formed) with the permanent cusp (canine) erupted on the place of the missing incisor and the deciduous canine in place. On the left sight of the upper arch she had an atypically lateral incisor and the permanent canine erupted on the palatal side in cross-bite.
She had difficult in mastication, speech and overall esthetic problems.
I decided to keep in place the deciduous canine till the growth ends so it will be possible to put an implant in place and to reconstruct with composite the malformed left lateral incisor.
After the braces were removed and esthetic reconstruction of the lateral incisor was complete, she was so happy about her teeth that she said: “ I feel like a star”. It is funny what she said but she really had a gorgeous smile, I let you judge it J.
Congenital missing upper lateral incisors and impacted canine
1 year and half of treatment.
The patient aging 12, referred to me as she had congenital missing upper lateral incisors and an unerupted tooth (left upper canine impacted).
Since canines present with a high demand on aesthetic and functional requirements, alignment of impacted canines into the arch is the best treatment approach. The upper arch was bonded and created enough space for bringing into the arch the impacted canine. It was surgical the surgical exposure of the impacted canine and the application of traction forces to an attachment on the impacted tooth.
After the braces were removed the right canine was reshaped to look like an incisor.
Third class malocclusion with cross-bites and traumatic fracture of one incisor edge
1 year and half of fixed orthodontic treatment, ceramic braces
Patient 21 years old was referred to me by a general dentist.
She presented the lower incisors crowded with no space for alignment, one of the lower incisors had a trauma and the incisal (cutting) edge got fractured. She had a very bad hygiene. Because it was no space for the alignment I decided to extract the fractured lower incisors. I decided to remove the braces even the occlusion wasn’t perfect because of the very poor hygiene and the risk of enamel demineralization.
Photo with the fixed appliance in place after 8 months of treatment
Frontal deep bite and crowded frontal teeth, traumatic incisor edge fracture
1 year and 3 months of orthodontic treatment.
Patient 21 years old referred to me because of the crowded teeth and the fracture of incisor edge because of the deep bite.
In order to create space for the alignement of all the teeth I had to perform interproximal enamel reduction (stripping). He had to wear interarch elastics for 3 months to obtain good intercuspidation.
After the braces were removed I performed the aesthetic reconstruction of the fractured incisor edges.