Interdisciplinary orthodontic camouflage treatment with extraction of fractured maxillary central incisor and tooth substitution to treat skeletal bimaxillary protrusion- A case report

Abstract

Malformed or fractured central incisors with poor prognosis could be the choice of teeth for extraction when space is required for orthodontic treatment. This case report refers to a 14-year-old girl who had a fractured upper left central incisor associated with bimaxillary protrusion. She expressed her concern to correct her dental appearance and enhance her smile aesthetics. The patient had class I malocclusion with bimaxillary proclination and severe crowding in the lower arch. Due to the increased space requirement, extraction of teeth was required as part of orthodontic treatment. Patient had a class 2 skeletal profile with prominent upper front teeth and therefore increased space requirement in the upper arch in order to retract the prominent teeth to achieve favourable aesthetics. The choice of teeth for extraction were 14,34,44 and 21. In the second quadrant the central incisor was extracted due to its poor prognosis, and the lateral incisor, canine and first premolar were substituted for the central incisor, lateral incisor and canine respectively. In the lower dental arch the first premolars were extracted. The end of treatment objectives- class 1 molars, canines, incisors were achieved with greatly improved smile aesthetics. KEYWORDS Interdisciplinary orthodontics, Teeth substitution, Poor prognosis, Incisor extraction.