Figure 1

Patient example of a 28y old male; A) Diagnosis: previous orthodontic treatment as a child; missing both upper lateral incisors and canines; maxillary transversal deficit; anterior crowding in the mandible; anterior edge-to-edge bite; B) Lateral cephalogram with an inserted PI, after a previously performed surgically assisted rapid maxillary expansion (SRME). C) Multi-functional anchorage purposes: mesialization of the right upper lateral teeth, distalization of the left upper lateral teeth, replacement of missing upper lateral incisors. D) Applied Class II elastics for mesialization of the lower teeth for gap closure (after extraction of the first premolars to resolve the anterior crowding). E and F) Final situation after removal of the orthodontic appliances and insertion of dental implants in the region of the upper lateral incisors. The first upper premolars were shaped and build up with composite to fit as a replacement for the canines.