Multidisciplinary orthodontic and prosthetic treatment of an eleven year old patient with a solitary median maxillary central incisor: A case report

Abstract

Solitary median maxillary central incisor (SMMCI) syndrome is a rare developmental disorder in which a patient presents with only one upper central incisor located in the midline, along with some other features - such as deviant sella turcica and pituitary gland morphology, panhypopituitarism, hypothyroidism, and hypoplasia of the inner genitals - that may or may not be present. Although some authors consider it a mild manifestation of holoprosencephaly, others classify it as a distinct entity. The aim of this case report is to describe the orthodontic treatment of an 11-year-old female patient with SMMCI. The patient presented with early permanent dentition, Class II, division 2, subdivision (left) malocclusion on a Class I skeletal pattern, a solitary median maxillary central incisor, and moderate crowding in the lower dental arch. Orthodontic treatment was carried out using fixed appliances, involving the creation of space for an additional maxillary central incisor and the correction of Class II malocclusion through the application of intermaxillary elastics. By the end of treatment, Class I canine and molar relationships had been achieved, the overjet and overbite became optimal, and a one-wing Maryland bridge was placed in the area of the left maxillary central incisor. Regarding retention, a lower fixed retainer from canine to canine and upper and lower vacuum-formed appliances were used. In conclusion, this case report highlights the importance of coordinated care among dental specialists for effectively treating solitary median maxillary central incisor cases.