2022 Volume 82 Issue 5 Pages 415-424
Congenital absence of permanent teeth and anomalous crown morphology can cause dental occlusal abnormalities and esthetic disorders. It is difficult to obtain satisfactory functional and esthetic results in such cases, even if orthodontic treatment or prosthodontic treatment alone is attempted to improve the situation. However, the overall quality of treatment can be improved by implementing a plan that combines both orthodontic and prosthodontic treatment. This study aimed to present a case of a patient with congenitally missing teeth and a peg tooth who was treated with orthodontic and prosthodontic treatment with satisfactory functional and esthetic results. A 20-year-and-4-month-old woman presented for improvement of spaces and treatment of malocclusion of the left molars. She had skeletal class Ⅲ malocclusion with congenital absence of the maxillary right lateral incisor and the mandibular left second premolar, peg maxillary left lateral incisor, distal inclination of the mandibular left first premolar, and mesial inclination of the mandibular left first molar. The treatment plan was decided in collaboration with the prosthodontist. The orthodontic treatment was a nonextraction treatment. The teeth were aligned, and the spaces were controlled with an edgewise appliance. The congenitally absent teeth and the peg tooth were aligned to create a space for prosthodontic treatment, and the spaces were closed with implants. Thus, a class I molar relationship was established. Protrusive guidance by the central incisors and lateral guidance by the canines were also obtained. The spaces were closed by prosthodontic treatment, the midline of the face and dentition were aligned, and the teeth were arranged symmetrically, resulting in an esthetic and functional occlusion.
