Case 8.5 Patient who had lost the left lower first molar due to caries years earlier. (1-3) Extraoral image before treatment. (4-8) Occlusal at start of treatment. Following the extraction, the second molar had tilted mesially and the canine and premolars had tilted distally resulting in a distal canine and premolar relationship on the left side resulting in an asymmetric lower arch. The upper first molar had extruded and tilted slightly bucally. In addition, the bite was deep with gingival impingement and the incisors demonstrated abrasion reflecting a posterior forced bite. (9-13) A bite plate was inserted and the over-erupted molar was intruded and lingually tipped against a mini-implant inserted in the palate. (14,15) In the lower arch the asymmetry was corrected and the space for the missing molar reopened. An implant was inserted and following the intrusion of the upper molar, a crown could be added to the implant. (16-23) Status at the end of reconstruction.

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