Realistic Objectives in Orthodontic and Prosthetic Treatment of an Elderly Patient with Deep Overbite: A Case Report

Abstract

Abstract Orthodontics plays a crucial role in the restoration of oral health in adult patients, particularly when treatment objectives are grounded in accurate diagnoses that respect biological limitations. This case report describes the orthodontic management of a 65-year-old male patient presenting with Angle Class II, division 2 malocclusion. The patient was referred for orthodontic intervention to improve conditions for restoring mandibular incisors. Clinical examination revealed extensive restorations, black triangles between maxillary central incisors, severe incisal wear on mandibular incisors, and gingival recession in maxillary premolars and molars. Radiographic findings included root shortening of maxillary incisors and significant alveolar ridge resorption in the maxillary molars. The complexity of the case was heightened by the patient's age, extensive dental restorations, significant alveolar bone resorption, and gingival recession, requiring meticulous planning to address functional, esthetic, and biological challenges. Treatment was planned with realistic objectives, utilizing partial fixed orthodontics in the maxillary arch, focusing on alignment and leveling while maintaining posterior intercuspation. Interproximal reductions were performed on maxillary incisors to minimize black triangles and improve esthetics. After 10 months, orthodontic objectives were successfully achieved. Retention included a fixed retainer on the maxillary central incisors and an occlusal splint for the maxilla. This case highlights the importance of individualized and multidisciplinary approaches in orthodontic treatment for elderly patients, demonstrating how orthodontics can complement prosthetic rehabilitation to achieve functional and esthetic outcomes.