Page 42 - DP Vol 20 No 3

OrthOdOntic sectiOn

INTERDISCIPLINARY ORTHODONTICS:

A CASE SERIES

Gurkeerat Singh, Payal Mahajan, Sachin Philip, Lalfakzuali, Ankur Kaul

INTRODUCTION CASE 1
The advancement of dental specialities has improved the quality A 42-year-old female patient presented with the chief complaint of a lack
of treatment for adult patients. Historically, orthodontics was of visibility of the upper teeth when smiling. The patient had a skeletal
primarily practiced on children and adolescents in solo practitioner Class III tendency and a prominent chin that was slightly displaced to
settings. However, orthodontists are increasingly leading the right. Extra-orally, on her frontal smile, only the incisal one-thirds
interdisciplinary teams to enhance outcomes for adult patients of the maxillary anterior teeth were visible. Intra-orally, the patient had a
with complex dental disorders. Orthodontists are now seeing more crossbite involving teeth 13, 15, 16, and 17 due to a constricted maxilla.
patients for both primary malocclusion corrections and adjunctive Mandibular deviation was observed along with generalized attrition
therapies for periodontal diseases, edentulous areas, or hopeless (Figure 1).
teeth. Adult patients now account for over 40% of new patients Since the patient was an adult, the maxillary transverse deficiency was
in most orthodontic offices. Adults with mutilated dentitions and planned to be corrected through MARPE (Mini-Implant Assisted Rapid
associated stomatognathic diseases require different therapeutic Palatal Expansion). Sufficient expansion was achieved with the appearance
targets and rules than children and adolescents. To effectively of a midline diastema, followed by the correction of the crossbite (Figure
address compromised adult malocclusions, orthodontists must 2). The maxillary and mandibular arches were aligned and settled using
collaborate with periodontists, oral and maxillofacial surgeons, clear aligners (Figure 3). Since the patient was concerned with the
and restorative dentists. Two cases are presented which highlight aesthetic appearance of her teeth, full mouth rehabilitation was done
the role of orthodontic intervention prior to restorative dentistry using anterior veneers and posterior crowns (Figure 4). Post-treatment,
to provide optimal results for the patients. the patient achieved more than 85% of Morley’s ratio during her smile,
effectively addressing her chief concern (Figure 5).

cAse 1

Fig 1a Fig 1b Fig 1c

Fig 1d Fig 1e
Fig 1: Pre-treatment intraoral photographs
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40 Dental Practice I May-June 2024 I Vol 20 No 3