• Chatsuda Pawasoottikul, D.D.S.
• Chalermpol Leevailoj, D.D.S., M.S.D., ABOD., FRCDT.
• Niramol Chamnannidiadha, D.D.S., Dr.med.dent., Diplomate, Thai Board of Orthodontics

This article is a case report of a patient who lost left permanent maxillary lateral incisor,
canine and left permanent maxillary first premolar and alveolar bone due to the enucleation of
eosinophilic granuloma. Also, the report described how a multidisciplinary approach may improve the
esthetic outcome when only orthodontic treatment was insufficient. The early loss of permanent
anterior teeth affected the harmony of the incisors shown and ultimately the esthetics of the smile, and
was a challenge in treatment planning. The recurring esthetic dental (RED) proportion was used for
space distribution. Esthetic crown lengthening was indicated to improve the gingival levels. Indirect
porcelain veneers were used for tooth shape correction and space closure. The tooth alignment
was maintained using orthodontic retainers. The follow-ups at 1 week, 1 month, 3 months and
6 months presented a very healthy gingiva. The patient was satisfied and felt more confident on
her new pleasing smile.

(CU Dent J. 2012;35:201-12)