Treatment and retention of a mandibular arch telescoped within the maxillary arch: case report

A patient in the early mixed dentition was experiencing "difficulty in eating." The right mandibular posterior teeth were telescoped within the maxillary arch. The mandibular midline deviated to the left of the maxillary midline. With the midlines aligned, posterior occlusion was minimal. By activating a lingual arch, the mandibular arch width was increased to establish a posterior occlusion. Also, the lingual arch was used as a retainer. The posterior occlusion remained stable throughout the mixed dentition. An unexpected second phase of treatment was indicated in the permanent dentition because the maxillary right first and second premolars and the maxillary right second molar were completely buccal to the mandibular teeth. Successful treatment was accomplished in spite of broken appliances and noncompliance.