Clinical cases                                                                  #39

Congenitally missing maxillary right lateral incisor, peg maxillary left lateral incisor,  Angle Cl III occlusion, crossbite and bimaxillary retrusion in a 12-yr-old girl treated with maxillary expansion, extraoral traction with a facemask and Alexander type fixed appliances.
Treatment plan and sequence:  saggital expansion and forward traction of the maxilla, alignment of the maxillary arch, restoration of the right max. lateral incisor space and anatomical modification of the left, correction of the midline and alignment of the mandibular arch.

Algunos valores cefalométicos:           SNA:                   75           SNB:                   76           ANB:                    -1            < Facial:               87           FH-Mandibular:   30           SN-Mandibular:   39           Goníaco:            130           Interbasal:            26                                         Eje Y:                  60           1/ a Max.             78           1\ a Mand.           73           Wits:                    -7

First phase of treatment:  Expansion of the maxillary arch combined with a facemask to create space laterally and move the maxilla forward

Alignment of the maxillary dental arch and placement of a lateral incisor in the resulting space.  Extraoral traction is still being used.

Results obtained 3 yrs. post- treatment.  The left peg lateral was modified in size and a provisional prosthesis was placed on the right until a decision is made about a final, permanent replacement.

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