Orthodontic treatment of mandibular incisor agenesis with Herbst appliance in a patient with Hanhart syndrome: A 12-year follow-up.

This case report presents an unusual multidisciplinary treatment and longitudinal follow-up of a female patient with complete agenesis of the mandibular incisors, diagnosed with Hanhart syndrome. The orthodontic treatment started when aged 11 years and comprised orthodontic traction of the impacted permanent maxillary canine, followed by a Herbst appliance for mesial movement of the mandibular posterior teeth and reduction of the agenesis space. The mandibular canines replaced 2 out of 4 absent incisors, and 1 dental implant was placed between the mandibular right canine and the first premolar. A satisfactory final occlusion was achieved, and the 12-year follow-up showed the stability of results. Multidisciplinary and individualized treatment is important for an adequate rehabilitation of craniofacial patients presenting multiple agenesis.