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The Clinical Challenge: Complex Trauma and Bite Misalignment
When Mya first attended our practice as a child, her dental history was heavily compromised due to her childhood injury. A comprehensive clinical evaluation revealed:
- Severe Skeletal Discrepancy: A Class II Division 1 bite with a severe overjet, an upper crossbite, and a near-scissors bite on her premolars.
- Developmentally Damaged Front Teeth: Both upper central incisors (teeth 11 and 21) and lateral incisors (teeth 12 and 22) were poorly formed with guarded long-term prognoses, dark underlying dentine, and thin, fragile enamel.
- Compromised Endodontic Health: Years of breakdown and repeated direct restorations had left minimal natural tooth structure remaining.
The Comprehensive Multidisciplinary Care Programme
To give Mya a functional bite and protect her vulnerable front teeth, our team designed a phased, long-term treatment plan spanning her adolescent years into young adulthood.
[Childhood Trauma & Severe Overjet] ➔ [Twin Block Jaw Expansion] ➔ [Fixed Damon Braces] ➔ [Endodontic Intervention] ➔ [Empress Direct Composite Smile Reconstruction]1. Phase One: Twin Block Orthopaedics & Fixed Braces (2018 – 2021)
We began treatment with custom-moulded Twin Block functional appliances to expand her arches and correct the Class II jaw mismatch. Following successful jaw expansion, fixed metal braces were bonded to both arches to align the teeth and eliminate crossbites. The braces were de-bonded in early 2021, and Mya was fitted with clear Essix retainers, later transitioning to a custom upper nightguard to protect her teeth against night-time grinding (bruxism).
2. Phase Two: Emergency Endodontic Referral (Mid-2024)
In June 2024, Mya presented with localized gum sensitivity and a pulsing sensation above her upper left front tooth (tooth 21). Dr Emmet Ryan conducted a thorough examination and identified a sinus tract indicative of non-vital pulp breakdown—a direct delayed sequela of her childhood intrusion trauma. Dr Ryan immediately prescribed antibiotic cover and co-ordinated a specialist endodontic referral for root canal therapy to stabilize the infection before any further cosmetic work could begin.
3. Phase Three: Boutique Whitening & Empress Direct Reconstruction (Late 2024)
Once the endodontic treatment stabilized the root, general dentist Dr Stephen Taylor took over the aesthetic restoration of her front teeth:
- Targeted Whitening: Mya completed a tailored bleaching regime using 16% Carbamide Peroxide custom trays to lift the overall shade of her natural teeth.
- Empress Direct Composite Build-Ups: In December 2024, Dr Stephen Taylor executed a complex aesthetic reconstruction. Under local anaesthetic, he carefully removed the broken, discoloured composite material, managing dark dentine and enamel white spot lesions. Using gingival retraction cord and celluloid matrices, Dr Taylor meticulously sculpted Empress Direct A1 enamel and dentine composite resin over her upper front teeth (12, 11, 21, and 22), recreating natural translucency, full anatomical contours, and a radiant smile line.
Long-Term Maintenance and Emergency Care (2025)
A heavily restored smile requires ongoing protective care. Throughout 2025, Dr Stephen Taylor performed minor, non-invasive composite chip repairs when hard foods (such as bacon fries) compromised the thin enamel edges, ensuring her custom Essix retainers continued to fit perfectly.
In December 2025, when Mya experienced acute pericoronitis (painful gum inflammation around an erupting lower wisdom tooth), Dr Taylor provided immediate relief with a targeted course of Metronidazole and chlorhexidine rinses, fully resolving the infection within days.
The Life-Changing Result
Mya’s journey represents the pinnacle of multi-specialty dental care. By combining growth modification, fixed braces, specialist root canal therapy, and high-end Empress Direct composite bonding, our clinic transformed a severely traumatized, discoloured front profile into a radiant, fully functional smile.
The Specialist Advantage: Severe childhood dental trauma requires a clinic that can manage tooth movement, root health, and cosmetic restoration seamlessly under one roof. At Dublin Orthodontist, our co-ordinated team approach ensures every patient receives an uncompromised, lifelong standard of care.
Reclaim Your Smile Confidence
Whether you are dealing with past dental trauma, complex bite issues, or heavily restored front teeth, our specialist Dublin team is here to design a custom treatment plan for you.
