Conclusion
This case report documents the management of a severely infraoccluded primary molar, an impacted second premolar and a congenitally missing premolar tooth which resulted in significant surgical and orthodontic challenges. Comprehensive planning and careful orthodontic treatment, including use of temporary anchorage devices (TADs), effectively addressed the presenting malocclusion. Although this ambitious orthodontic treatment did not attain an ideal occlusion, favourable outcomes were achieved with respect to alveolar bone regeneration, avoidance of future prosthodontic rehabilitation and spontaneous mandibular third molar eruption.