Lingual Orthodontics. Open bite, severe overcrowding. Gum graft

This is a very serious overcrowding case. It was solved by the expansion and the distal movement of the upper arch.

The upper right second molar was extruded because of the lack of its antagonist (the lengthy absence of the lower second molar had caused it to continue erupting).

The choices of treatment on the table were:

1) Intruding the tooth (placing it at the right level) and placing an implant to replace the lower molar.

2) Extruding the first molar affected by a major makeover in poor condition, and intruding and doing a mesialization of the second molar.

3) Extruding the second molar and moving it distally using micro-screws in the retromolar sector.

The patient chose the third option to solve the overcrowding. The recessions (loss of gum) detected before the treatment were treated by means of connective tissue grafts (gum grafts).