A 19-year old patient reported with mid face deficiency, un-erupted teeth and functional bite problems, his history revealed that he has another elder brother with the same birth condition. His chief concern was functional class III bite problems as well as poor aesthetics. He was clinically examined thoroughly to diagnose and label his condition. On examination, it was seen that he was able to join his shoulders (hypoplastic clavicles), mid face deficiency and relative mandibular prognathism, while hypertelorism was also noticed. On intra-oral examination, a high maxillary arch with all permanent teeth were found to be fully erupted except 3rd molars, right and left canines, incisors and left 1st premolar. The right central incisor was partially erupted. Left deciduous canine was retained. In the mandibular arch, relatively less permanent teeth were erupted. The teeth found missing were 3rd molars, all premolars except left 2nd premolar, right lateral incisor and both canines. The right 2nd deciduous molar, right and left deciduous canines and right deciduous lateral incisors were found retained. The crowns of all permanent 1st molars were grossly carious but without involvement of the pulp. The oral hygiene was not satisfactory with generalized plaque and calculus. After initial periodontal, conservative and extraction treatment, patient was ready for the dentures. On radiographic assessment (OPG), un-erupted teeth were present along with five supernumerary teeth in the lower arch and one in the upper arch.
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