Case 8.3 (1-3) Extraoral images of a 54-year-old woman with a visible cant of the occlusal plane. The patient was wearing a fully balanced splint most of the time as she was suffering from pain related to both joints. A clinical examination indicated a posterior and lateral forced bite. (4-6) Occlusal at start of treatment. An overbite with palatal impingement and a left scissor bite was characterising the occlusion. (7,8) Both the upper and the lower arches were asymmetrical. The width of the left upper arch was larger than the right, the left lower arch was narrower than the left. (9-11) The treatment was initiated in the lower arch with the cantilever extending from the right canine to the left premolar region, widening the lower arch in the left side. During this period the patient was wearing the splint continuously as she was in pain whenever it was removed. This also prevented traumatic occlusion to the lower premolars being moved bucally. (12,13) Occlusal view of the first stage of treatment. The splint was adapted so that the two overerupted premolars could be intruded against a mini-implant in the palate. Without the splint the patient had only one contact on the build-up added to the right molars. Without the splint the patient would not be able to eat and thereby the compliance was insured. (14-16) During the first stage of treatment the midline was spontaneously corrected and when the scissor bite was corrected, the lowering and gradual removal of the splint was started. (17,18) The asymmetry of the arch form has not been corrected and the onlay on the molar has been removed. (19-21) When the scissor bite has been corrected, slight eruption was generated in the right side by intermaxillary elastics. (22,23) Arches before the last stage including continuous arches and levelling. (24-26) Extra-oral image (note that the occlusal plane is not parallel to the inter-pupillary line). (27-31) Occlusion at the end of treatment.

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