Orthodontic anterior teeth space closure in an adult with posterior long standing fixed partial denture

Abstract

This is a case report of a 40-year-old female patient with chief complaint of spacing in front teeth. Patient exhibited convex profile, incompetent lips, spacing in anterior maxillary and mandibular teeth. She had maxillary posterior long span fixed partial denture and generalised periodontitis. She was diagnosed as Class I malocclusion with proclined and spaced anterior teeth. Treatment objective include space closure, maintaining class I molar and canine relation, achieving ideal overjet and overbite and functional occlusion. Thorough oral prophylaxis was done prior to start of fixed mechanotherapy. The case was bonded (upper canine to canine and full lower arch) with 022 MBT bracket system. Aligning and levelling was done sequentially with 012,016,17x25 Niti wires. One bracket each side was bonded on the maxillary FPD abutment teeth for anchorage. Space closure was achieved using low forces with elastomeric chain on 19x25 SS wire. Total treatment time was 12 months. Ideal overjet and overbite achieved with functional occlusion. Periodontal condition improved and stable results were achieved. Patient is given fixed retention and removable hawleys retainer with tongue crib in upper arch. In the recent years, there has been an increase in number of adults seeking orthodontic treatment and orthodontists quiite often face patients with periodontal disease. Adult patients should follow regular oral hygiene measure in order to maintain periodontal health during and after active orthodontic therapy.