Management of skeletal class I malocclusion in a patient with lateral incisor agenesis and deep bite

Abstract

Background: This case report describes the orthodontic management of a 28-year-old female patient with a Skeletal Class I malocclusion characterized by maxillary lateral incisor agenesis, deep bite, and retained deciduous teeth. Objective: To explain the malocclusion Class I with maxillary lateral incisor agenesis, deep bite, and retained deciduous teeth treatment approach using the Preadjusted Edgewise MBT fixed appliance (Mini DiamondTM, Ormco). Case management: A 28-year-old female patient with Class I malocclusion with unilateral maxillary lateral incisor agenesis also presented with deep bite, retained primary teeth, and microdontia, specifically a peg-shaped lateral incisor. The treatment goal was to improve aesthetics and masticatory function without tooth extraction. Management of maxillary
lateral incisor agenesis involved canine substitution. The deep bite was addressed by various leveling methods,
such as incisor intrusion or molar extrusion, to correct the vertical discrepancy. Results: By carefully managing the agenesis through canine substitution and preserving retained primary teeth with favourable crown-to-root ratios, the treatment successfully maintained alveolar bone and achieved a stable, aesthetic result. Proper mechanotherapy not
only met the patient’s expectations but also ensured treatment efficiency and prevented complications such as root resorption.