Adult Multidisciplinary Treatment of a Severe Malocclusion

This patient was concerned with crowded teeth and an underbite.

Upon Examination, he was found to have a crossbite of the back teeth and the front teeth.  A crossbite is when the upper teeth do not fit around the lower teeth.  Instead, the upper teeth are positioned closer to the tongue than the lower teeth.  In the front of the mouth, this is called an underbite.  In the back of the mouth, this is called a posterior crossbite.

 He was also found to be missing one front tooth and a tooth on the right side of his mouth near the back.

In order to expand the upper jaw, we placed an appliance called a rapid palatal expander.  This appliance works in youth and adolescence simply by turning the screw mechanism once or twice per day.  In adults, because the bones are not as malleable, an adjunctive surgical procedure is needed to weaken the upper jaw so that it can be expanded.  Once the expansion is complete, the bones heal in the new expanded position.  This patient underwent maxillary (upper jaw) expansion surgery at the time the appliance was placed.

This is a picture of the lower teeth.  There was significant crowding of the lower teeth.  Because of the missing teeth in the upper jaw, it was decided that two teeth would be removed from the back of the lower jaw to create room to resolve the crowding and to match the number of lower teeth to the number of upper teeth.

After tooth alignment, the teeth were ready to have veneers placed.  The veneers were designed to make the teeth that were substituted to replace the missing front tooth look more natural.  They also were made longer so that more teeth were exposed when he smiles.

The veneers also provided a whiter tooth color to enhance his smile.

A happy patient who now can't stop smiling!!!