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ePaper created 2014-10-09, 17:54:05 | version 1.30.01
23dentistry 3_2014 cosmetic case report _ biomimetic approach approach to the treatment of our patients, we can achieve satisfying results aesthetically and functionally. The aim of the biomimetic approach is to respect nature and effect as little irreversi- ble change as possible. It is very important for young adult patients, whose entire lives lie befo- re them, and has a great influence on their tre- atment planning, especially in patients with mul- tiple agenesis Undoubtedly, this is a therapeutic challenge and requires extensive knowledge, experience and close collaboration between dif- ferent specialists in dentistry. _Case description A 19-year-old female sought treatment at the Department of Orthodontics at the Medical University of Warsaw because of her congenitally missing permanent teeth (Figs. 1a, b). During an interview, she reported that her brother and mo- ther also had several missing teeth. Clinical exa- mination revealed a persistent primary maxillary right second molar, the absence of all maxillary premolars, two mandibular second premolars and one mandibular incisor. A panoramic radiograph confirmed the absence of the seven permanent teeth above and all third molars (Fig. 2). _Occlusal analysis The midline of the maxillary arch did not coin- cide with the facial midline. The midline of the mandibular arch could not be assessed owing to the presence of three mandibular incisors. The la- teral crossbite on the right side was present from the lateral incisor to the last tooth in the arch. Figs. 5a-d_Occlusal contacts after orthodontic treatment, showing the rounded shape of the maxillary incisors. Figs. 6a, b_Plaster models without (a) and with the diagnostic wax-up (b). Fig. 7_A panoramic radiograph after implantation. Figs. 8a-c_Delayed implantation of the implant in region 14. Fig. 5b Fig. 5d Fig. 6a Fig. 8a Fig. 6b Fig. 8b Fig. 7 Fig. 8c Fig. 5a Fig. 5c