Case details

Category

Orthodontics

Case Description

The patient presented with issues related to bruxism and worn dentition, primarily affecting the upper and lower anterior teeth, along with a deep bite.

The lower front teeth had erupted compensatorily as they wore down. Additionally, the patient had lost the upper left second premolar.

Orthodontically, the objective was to correct the deep bite using a fixed orthodontic appliance and reposition the teeth to their original locations before the wear and interlocking began. This repositioning enabled prosthetic restoration of the lost tooth structure using crowns, thus restoring aesthetics and function, while protecting the remaining dentition from further wear.

Furthermore, by using a temporary anchorage device (TAD, mini-implant) , the space left by the missing upper left second premolar was closed by moving the upper left first and second molars into the space.

This approach eliminated the need for a dental implant to replace the missing tooth, allowing the patient to retain only natural teeth—an advantage both economically and biologically.

At the conclusion of orthodontic therapy, all six of Andrews’ keys to normal occlusion were achieved, which we always emphasize due to their importance for long-term stability, oral health, and optimal masticatory function. These keys include: alignment of the upper and lower dental midlines, placement of the upper canines behind the lower canines in Class I relationship, upper incisors overlapping the lower incisors vertically by the ideal 2 to 3 millimeters with a gentle curve of Spee, correct tooth angulations, absence of tooth rotations, and closure of all interproximal spaces.

The teeth were positioned optimally to allow for minimal tooth preparation during the prosthetic phase of restoring lost dental structure—essential for successful crown placement in this case.

The result is a beautiful smile and restored dental function, while preserving the remaining natural tooth structure from further degradation.

Orthodontic treatment was performed by orthodontist Marko Grgurić, and prosthetic rehabilitation was carried out by Dr. Željko Kovač, a dental medicine specialist with advanced training in aesthetic dentistry.