Abdullah Fa, Sangsuwon C, Alansari Sa
Figure 1: Pretreatment extra- and intra-oral photographs. Portrait photographs before initiation of treatment show a straight profile, slightly asymmetrical face due to mandibular deviation to the right side, dark buccal corridors an 80% incisal display while smiling. Intraoral photographs reveal a constricted maxilla, anterior open bite, anterior and posterior crossbites, crowding and proclined maxillary anterior teeth. Wear facets can be observed in several teeth suggesting a gridding habit.
Figure 2: Pretreatment panoramic radiograph. Panoramic radiograph shows a complete dentition except for the absence of upper second and lower first premolars, spindle-like roots on molars, mild to severe root resorption of the maxillary central incisors, canines and premolar, and the lower right canine and premolar. Asymmetrical condyles show some degree of remodeling and asymmetrical position. Panoramic radiography showed an area of idiopathic sclerosis close to the root of the second left molar.
Figure 3: Pretreatment lateral cephalometric radiograph and analysis. Cephalometric analysis clearly shows the anterior open bite, class I skeletal relation of maxilla and mandible, counter-clockwise rotation of the maxillary occlusal plane, normal inclination of the mandibular plane, and proclined upper incisors.
Table 1: Cephalometric Analysis Pre- and Posttreatment.
Figure 4: Posttreatment extra- and intra-oral photographs. Post treatment photographs demonstrate correction of the open bite, expansion of the maxilla and correc- tion of the crossbites, correction of mandibular deviation, coinciding midlines, establishment of a Class I molar and canine occlusion, and ideal overjet and overbite.
Figure 5: Posttreatment panoramic radiograph. Panoramic radiograph at the end of treatment shows good root parallelism and no increase in root resorption. The idiopathic sclerosis close to the root of the second left molar did not undergo any changes during the course of treatment.
Figure 6: Posttreatment lateral cephalometric radiograph and analysis. Post-treatment cephalometric analysis shows correction of open bite, improvement in maxillary incisor inclination, overall improvement in relation between maxillary and mandibular dental arches and ideal overjet and overbite.
Figure 7: Superimposition of cephalometric analysis of pretreatment and posttreatment. Cephalometric superimposition on the anterior cranial-base demonstrates retroclinaiton of maxillary anterior teeth, extrusion of both maxillary and mandibular anterior teeth and flattening of the occlusal plane (A). Superimposition based on the body of maxilla, shows molar uprighting and incisor retroclination and extrusion (B). Superimposition based on inferior-alveolar nerve and inner profile of the mandibular symphysis demonstrates incisor extrusion and molar uprighting (C).