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Managing Complex Malocclusion Following Childhood Odontoma: An Interdisciplinary Approach
Rahmadika Kemala Firdausia1, Stephanie Adelia Susanto2, David Sugihartana2
1Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Abstract:
Loss of the maxillary anterior teeth in childhood following an odontoma can set the stage for a complex malocclusion with enduring effects on facial esthetics, function, and psychosocial health. We report the management of a 15-year-old boy who presented 8 years after odontoma excision with an anterior maxillary defect, rightward dental midline deviation, crowding, and a crossbite. Treatment combined passive self-ligating brackets with customised torque, nickel-titanium open-coil springs for controlled space regaining, and an infrazygomatic crest temporary anchorage device to drive asymmetric midline correction. At debond, a Lucitone-based removable partial denture restored anterior form and function. After 12 months of active therapy, occlusion was stable, facial symmetry improved, and the patient reported greater confidence. This case illustrates how coordinated orthodontic-prosthodontic planning that leverages contemporary biomechanics and age-appropriate prosthetics can deliver durable functional stability, esthetic enhancement, and meaningful psychosocial gains.
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