Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship achieved
• Functional canine guidance on both sides
• Normal overjet and overbite achieved
• Deepbite improved
• Significant improvement ofoverbite
• Midlines coincident
• Proper axial inclination of incisors
• Curve of Spee leveled
• Arches aligned and coordinated
• Alignment of both arches through derotation
• Arch form improved
• Aesthetic smile linewas achieved
• All treatment goals were achieved case
• Harmonic arches were achieved

Comments

• The chief complaint of this patient is the midline deviation of both upper and lower arches
• The patient presented with congenital missing of the 2.2 and peg lateral of the 1.2
• Therefore the upper midline was shifted to the left side
• The small-sized 1.2 was extracted to move the upper midline towards the right side
• The 1.2 and the 2.2 were substituted by the 1.3 and 2.3
• The lower midline was also shifted to the left side and the missing of the 3.5 was one of the reasons for this
• Therefore we extracted the 4.5 to move lower midline towards the right side
• We uprighted 3.4 and 3.6
• The lower curve of Spee was leveled to raise the bite