Page 29 - DP Vol 20 No 4 HR

upper dental midline to the right.
A bilateral sagittal split osteotomy was performed
using the Hunsuck and Dalpont modifications, with a
setback.
Finally, a genioplasty was carried out to balance the
facial profile.

Fig 5a-b: Eight weeks post-surgery, centerline correction Post-Surgical Orthodontic Phase:
Five Months
The aims of this phase were to:
• Settle the bite and achieve buccal interdigitation
• Establish a positive overjet and overbite
• Make minor alignment and torque adjustments
At each visit, I ensured that the skeletal and dento-
occlusal objectives had been met. Additionally, we
recorded the following information:
• Altered proprioception
Fig 5c: Eight weeks post surgery, canine Fig 5d: Eight weeks post surgery, • Extraoral swelling and bruising
correction lateralisation of the canine and intrusion • The patient’s general well-being and mood
of the premolar • The types of food and drinks the patient was
consuming
In collaboration with the restorative team, we began
making small adjustments to the teeth (Figure 5):
• Over several visits, the mesial and distal widths of the
UL3 were reduced
• The UL3 was also debulked buccally
• The UL4 was intruded by changing the bracket
position, which also intruded the gum margin
• Over time, the palatal cusp of the UL4 was selectively
ground to prevent occlusal interferences
Fig 6a Fig 6b
RESTORATIVE PHASE
After allowing sufficient time post-debonding for the
gums to settle, we proceeded with at-home whitening
using 10% carbamide peroxide over a two-week period.
This method is safe, reliable, and demonstrates very
slow color rebound.
This was followed by restorative masking to
reshape the upper left canine (UL3), lateralizing it, and
camouflaging the upper left first premolar (UL4) to
Fig 6c Fig 6d resemble a canine (Figures 6, 7 and 8).
Fig 6a-d: Restorative treatment – whitening and bonding

Fig 7a: One-year review, full face smiling Fig 7b: One-year review, side view Fig 7c: One-year review, angled smiling

Dental Practice I July-August 2024 I Vol 20 No 4 29