Orthodontic-Prosthetic Treatment Of An Adult With Crossbite And Missing Teeth

The aim of this case report is to show the multidisciplinary treatment of a 52 year old male patient with unilateral cross-bite and multiple missing teeth.

Method:

Clinical and radiographic examination revealed multiple missing teeth (12, 16, 21, 22, 24, 26, 37, 46), unsuitable metal-ceramic fixed partial dentures, unilateral cross-bite on the right side and displacement of the maxillary right central incisor. The migration of the central tooth was due to the extraction of the maxillary right lateral incisor and there were not adequate place to replace the missing teeth esthetically on the anterior segment. For this reason, orthodontic treatment was applied to the patient for correcting the cross-bite on the right side and for the prosthetic replacement of the maxillary right lateral incisor. The patient was treated using MBT appliance. Light labial forces were applied throughout treatment. Specially, wide form arch wires were preferred for expansion of maxillary teeth. An open coil spring was placed between maxillary right canine and central incisor to gain place for lateral incisor. After removal of the Ni-Ti arch wire, a stainless steel arch wire was inserted and kept in place for a period of 2 months. Treatment time with fixed appliances was 5 months. After finishing the orthodontic treatment, abutment teeth were prepared in a standardized manner and yttrium oxide partially stabilized zirconia (Y-TZP) ceramics were fabricated with the use of computer-aided design/computer-aided manufacturing (CAD/CAM) technique. All restorations were cemented using composite resin cement according to the manufacturer’s instructions.

Result:

The patient's esthetic and functional expectations were achieved. After follow up, healthy periodontal tissues around the abutment teeth were observed with perfect marginal adaptation.

Conclusion:

Multidisciplinary approaches would conclude with more successful results and higher patient satisfactions compared with conventional alternative treatment options especially for complicated cases.