Lower incisor extraction therapy in a complex case with an ankylosed tooth in an adult patient: A case report

Int Orthod. 2020 Dec;18(4):850-862. doi: 10.1016/j.ortho.2020.08.006. Epub 2020 Sep 15.


This case report describes a successful orthodontic therapy of an adult female treated by mandibular central incisor extraction and vestibular fixed appliances. The patient presented a skeletal Class I with normodivergent facial pattern, Class II subdivision dental relationship, extremely deep Curve of Spee and severe overbite. Moreover, during the treatment, the upper left first molar does not respond to orthodontic forces due to tooth ankylosis, augmenting the difficulty of this case. Despite this, a good occlusal relationship on both sites and an optimal extraoral outcome have been achieved after a 26-months therapy. To our knowledge no case report with such entity of Curve of Spee with contemporary tooth ankylosis has been presented.

Keywords: Adult treatment; Ankylosis; Dental class II; Lower incisor extraction; Severe curve of Spee.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dental Arch
  • Female
  • Humans
  • Incisor / surgery*
  • Malocclusion, Angle Class I / diagnostic imaging
  • Malocclusion, Angle Class I / therapy
  • Malocclusion, Angle Class II / diagnostic imaging
  • Malocclusion, Angle Class II / therapy
  • Models, Dental
  • Molar
  • Orthodontic Anchorage Procedures
  • Orthodontic Appliance Design
  • Orthodontic Appliances, Fixed
  • Orthodontic Wires
  • Overbite / diagnostic imaging
  • Overbite / therapy
  • Patient Care Planning
  • Radiography, Panoramic
  • Tooth Ankylosis / diagnostic imaging
  • Tooth Ankylosis / surgery*
  • Tooth Extraction*
  • Tooth Movement Techniques / instrumentation
  • Tooth Movement Techniques / methods*
  • Treatment Outcome