In this European Board of Orthodontics case presentation, Kieran Daly (Ireland) presents the treatment of a 12-year-old patient with a Class II Division 1 malocclusion and a missing upper central incisor following trauma. The case explores maxillary expansion, skeletal anchorage, space closure, tooth substitution, camouflage mechanics and digital smile design, highlighting the value of careful interdisciplinary planning in achieving stable functional and aesthetic outcomes.
Learning outcomes:
• Understand the diagnostic and treatment planning considerations for a growing patient with a Class II Division 1 malocclusion and missing maxillary central incisor.
• Explore the use of maxillary expansion, skeletal anchorage, premolar extraction and camouflage mechanics in managing complex orthodontic cases.
• Evaluate space closure and tooth substitution as alternatives to anterior implant placement in adolescent patients.
• Appreciate the role of interdisciplinary collaboration and digital smile design in achieving stable, functional and aesthetic outcomes.
