Pathologic tooth migration (PTM) is a common complication following moderate to severe chronic periodontitis, which lead to the undesirable consequences such as traumatic occlusion and impaired aesthetic appearance. Multidisciplinary approach had been successfully used in overcoming the problem. However, since periodontal tissue support is reduced in PTM, further migration of teeth may occur as they were always subjected to the external forces such as occlusion and soft tissue pressure during function. This case report described a 41 year-old male with a further migration of his upper right central incisor after periodontal therapy. After multidisciplinary approach was carried out to overcome the problem and the tooth was on stable condition, permanent splinting was placed to secure the tooth.

A perfect smile always relates to well-aligned teeth. Factors such as fracture, malocclusion, and tooth migration challenge a clinician to restore a patient’s appearance and functionality. This case report presented a 32-year-old Malay male patient concerns on his appearance because of a fractured maxillary canine due to motor vehicle accident. There has been no restoration on the tooth since three years ago. After obtaining the patient’s agreement, a full ceramic crown was constructed despite being complicated by Class III malocclusion. It is challenging to improve aesthetics and longevity for this patient with a midline shift and diastema of the lower arch, anterior cross bite of tooth 12, and an open bite between teeth 14 and 44. After discussion, the patient agreed and decided on a full ceramic crown of tooth 23 despite being challenged to achieve an ideal occlusion. The patient was satisfied with the crown’s quality and aesthetic.