Personalized Approach with Aligners in the Treatment of Multiple Agenesis in a Growing Patient: A Clinical Case

Aim: Personalized orthodontics allows to treat each patient's needs, optimizing timing, biomechanics, and outcome predictability. In multiple dental agenesis, individualized planning is crucial for effective space and aesthetic management. This study presents a growing patient with multiple agenesis treated through a digital workflow using clear aligners and miniscrews to achieve functional, aesthetic, and stable results. Materials and Methods: A 14-year-ald female patient presented with multiple dental agenesis, transverse and sagittal discrepancies, lower midline deviation, mandibular left shift, and a persistent thumb-sucking habit. After a comprehensive orthodontic evaluation, a customized clear aligner treatment plan was developed. The treatment included the extraction of teeth 55, 65, 74, and 84, torque control at the first and fourth quadrants, management and symmetrisation of spaces for the missing upper lateral incisors, and progressive alignment with attachments, interproximal enamel reduction, and intermaxillary elastics. In the final phase, after CECT evaluation of the anterior region, miniscrews were placed in positions 12 and 22 to preserve alveolar bone and manage temporary restorations until the end of growth. Results and Conclusions: The treatment successfully achieved symmetrical spaces for 12 and 22, corrected midlines and transverse dentoalveolar discrepancies, and resolved the mandibular shift, resulting in notable aesthetic and functional improvement. Regular follow-ups allowed dynamic adjustments to the treatment pian, leading to stable occlusion and proper preparation for final prosthetic rehabilitation. A personalized, interdisciplinary approach, combined with attention to psychological and communicative aspects, ensured patient compliance and overall therapeutic success.