Abstract
A 20 year-old dental student presented with a main complaint of dissatisfactory dental appearance. Her left maxillary canine was impacted, with poor prognosis. External root resorption had developed in the root of the adjacent maxillary lateral incisors. Treatment involved surgical extraction of the impacted left maxillary canine, which was substituted with a maxillary first premolar. The left maxillary lateral incisors were treated by endodontic pulp regeneration therapy. Periodontal regenerative surgery and upper arch expansion were used to treat upper arch constriction with unilateral crossbite, complicated by hard tissue deficiency surrounding the teeth. Combined periodontal surgery and orthodontic treatment were successful in managing the case. After 48 months of active treatment, the patient had a right-side class 1 molar and canine relationship, a left-side class II molar and class I canine relationship, and an ideal overjet and overbite. Cephalometric analysis indicated that the maxillary and mandibular inclinations were acceptable, and periapical X-ray showed good bone housing around all teeth.