1. Orthodontic and Composite build
up
Dr Jean-Marc Retrouvey
McGill University

2. Start of treatment
9 year old female
• Peg lateral incisors
• Narrow arches
• Moderate lower dental
crowding

3. Post maxillary expansion appliance
• Upper canine poorly
angulated
• Lateral incisor is peg
shaped

4. • Very light wire to bring
canine to the occlusal
plane
• Self ligating brackets

5. Tooth positioning
• Extrusion of the Lateral to get the best gingival margin as
possible
• Restorative dentist wants the lateral to be centered.
Usually I place it more distal to rebuild the mesial and
get a nicer anatomy

6. Final result: 12 months post treatment
• Same procedure was done on the right side and on
identical twin
• Lower lateral has intruded slightly