Horizontal tooth movement through atrophic edentulous alveolar ridge for bone formation

The absence of premolars is relatively common, occurring approximately 1.5% in the maxilla, but the absence of the both premolars in the same arch is rare and usually observed in cases of oligodontia. The objective of this article is to present a clinical case with a malocclusion in the permanent dentition and an absence of both premolars in the left hemiarch, and with the canine positioned adjacent to the maxillary left first molar. The movement of the canine was slow through the alveolar ridge in the edentulous region during movement. Rectangular arches associated with stainless steel open springs alternated with elastomeric chains were used to move the canine adjacent to the lateral incisor. The retention was with a Hawley type and an acrylic tooth while waiting for implant prosthesis placement. The orthodontic movement, even to a significant extent of the maxillary canine through the atrophic alveolar bone, generated new bone, obviating the need for bone grafting. The result with the implant placement of a premolar achieved good dental and functional occlusion with improved esthetics and periodontal health, which was evident by improvements in patient self-esteem and satisfaction.