28-year-old-patient, moved to Lugano from abroad. She was a user of fixed multibrackets which were only partially replaced. She showed no improvement in the upper alignment and especially lacked closure of the extractive spaces of the two first lower molars, permanently extracted at a young age. The severe mesoinclination of the lower molar seconds associated with the presence of lower molar thirds and anchoring difficulties made the treatment goal too ambitious. In light of this, the first two upper and lower molars were extracted, the upper and rectangular front teeth were aligned and straightened and the second lower molars were intruded, creating implant spaces suitable for the insertion of two premolars in place of the first lower molars. The patient’s profile was unchanged.
