Ortho-Prosthetic Management Of Deep Overbite With Microdontia

An adult with skeletal Class II low-angle deep overbite, microdontia of the anterior teeth, and congenital tooth absence was treated with clear aligners to distalize molars, creating space for aesthetic restoration of the upper anterior teeth, thereby improving occlusion and aesthetics. Mr. Zhang, a 34-year-old male, complained of misaligned teeth affecting aesthetics and occlusion. Examination revealed mild facial asymmetry, straight profile, bilateral molar and canine distal relationships, retained 53, malformed 23, microdontic 12/22, deep overbite (III degree), overjet (II degree), congenital absence of 13, retained 53, and skeletal Class II low-angle. Treatment involved clear aligners with implant anchorage to distalize molars, preserving mesiodistal space for 12/22, compensatory labial inclination of lower incisors with IPR, and intruding upper and lower anterior teeth to open the bite. Final treatment included veneers for 12/22/23 and crown restoration for 53, achieving improved occlusion and anterior aesthetics. In this skeletal Class II low-angle deep overbite case, compensatory treatment involved lower incisor proclination, molar distalization, anterior intrusion/posterior extrusion to mask mandibular deficiency, open the bite, and consolidate space. Aesthetic veneers and primary tooth crown restoration achieved stable occlusal/esthetic improvements maintained over 2 years. Skeletal Class II low-angle deep overbite with microdontic anterior teeth was successfully treated with compensatory orthodontics, improving facial profile and occlusion. Combined with restorative treatment, anterior aesthetics were enhanced, achieving satisfactory results for both the clinician and patient.