A young adolescent female, aged 17 years and one month, presented seeking orthodontic treatment to address the congenital absence of her maxillary lateral incisors.
The therapeutic aims were to provide an adequate aesthetic and functional occlusion, coupled with sound adjunctive periodontal tissue relationships and a favourable long-term prognosis.
The malocclusion was managed by customised lingual orthodontic appliances and the adjunctive use of direct skeletal anchorage derived from two palatal mini-implants.
The treatment objectives of good aesthetics, a functional occlusion, normal function, a healthy periodontium and a balanced profile were readily achieved. The retention records demonstrate the stability of the correction. The treatment duration was approximately 41 months, which encompassed the use of full fixed customised lingual appliances over a period of 24 months.