Comprehensive orthodontic treatment in an adolescent patient with Class II Division 1 malocclusion and ankylosed maxillary central incisors

While uncommon in orthodontics, the extraction of central incisors may be indicated when such teeth are of poor prognosis. This report details orthodontic treatment of a 13-year and 5-month-old Chinese female, who presented with Class II/1 malocclusion on a Class II skeletal jaw base relationship. Her maxillary central incisors were ankylosed and had undergone severe external root resorption following a previous traumatic episode. Orthodontic treatment involved removal of the maxillary central incisors and the mandibular first premolars. Pre-adjusted edgewise appliances with MBT prescription were used. To enhance anterior esthetics, prosthetic buildup of the four maxillary anterior teeth was performed before appliance removal. Tight intercuspation of teeth and optimal facial esthetics were achieved at appliance debond and maintained at 2-year follow-up.