Orthognathic treatment of patient with missing permanent first molars

ABSTRACT Purpose Due to the expanding demand for adult orthodontics, the number of cases which require comprehensive dental management is increasing. Adult orthodontic patients can exhibit multiple missing and/or heavily restored teeth, which could lead to an unusual extraction pattern for treatment. However, there is little existing evidence about adult orthodontic treatment of patients who present with irregular extraction. In the present report, we introduce a case with successful treatment outcome for complex problems, including anteroposterior skeletal discrepancy with multiple missing and heavily restored permanent teeth. Material and methods The patient was a 23-year-old woman case with skeletal discrepancy which required orthognathic surgery for correction. For her comprehensive dental condition, we decided to orthodontically close the spaces of her missing upper left first molar and her extracted lower left first molar. The upper space closure required sinus lift and bone graft to supply sufficient alveolar bone for tooth movement. The lower space was closed by sectional osteotomy at the time two jaw orthognathic surgeries were performed to correct her skeletal discrepancy. Results and conclusion At the end of the surgical and orthodontic treatments, functional occlusion and an improved facial profile were achieved. This case report provides new evidence and treatment procedures for patients who require a complex extraction pattern with orthognathic surgery.