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Main Instructor Orthdontic department/ Mackay Memorial Hospital
Department / Institution
Classification Case report
Hypodontia is the congenital missing of less than six teeth and is a common genetic craniofacial malformation in populations (Endo et al., 2006a).  The most frequent agenesis teeth are mandibular second premolars and maxillary lateral incisors, followed by the mandibular incisors and maxillary premolars.  Although agenesis of either unilateral or bilateral mandibular incisors is less common, its clinical manifestations often involves unstable occlusion, severe deep bite, residual overjet due to tooth-size discrepancies between dental arches and midline deviation.  Therapeutic treatment options vary with number of agenesis (unilateral or bilateral), midline deviation, craniofacial pattern and is further complicated by age. Reported treatment strategies of agenesis of bilateral mandibular incisors involve space regain for prosthetic rehabilitation or maxillary teeth extraction and camouflage treatment of mandibular dentition to achieve balanced occlusion.
This case presents a 13 year-old boy with Class I malocclusion moderate crowding, severe deep bite and congenital missing two permanent mandibular incisors. Treatment involves upper single arch extraction for crowding relieve and bilateral mandibular canines camouflage into lateral incisors.  Subsequent interproximal stripping and morphology recontouring of mandibular canines were performed to resolve Bolton discrepancies and achieve esthetic function.  At the end of the treatment, the patient achieved a harmonious facial profile with balanced occlusion.
Correction of Class I Deep Bite Malocclusion with Congenital Agenesis of Bilateral Mandibular Incisors