Case 11

Adult (permanent dentition)

Problems

Abnormal horizontal and vertical relationships between upper and lower anterior teeth

Anterior cross-bite (lateral incisors and canines)

Supernumerary (extra) lower incisor

Tooth size discrepancy between upper and lower 6 anterior teeth (big lower incisors)

Treatment

Extraction of the supernumerary and one additional lower incisor

Orthodontic treatment with fixed appliances

Complete space closure

Arch co-ordination

Establishment of normal horizontal and vertical relationships between upper and lower incisors