The adult first molar teeth were removed due to hypoplasia / hypocalcification at 9 years of age. No active orthodontic treatment was undertaken as it was not going to be possible to move the upper jaw forwards enough so that it would sit in front of the lower jaw. In these situations, the only way to achieve the correct positioning of the jaws is to surgically reposition them and this is normally undertaken when most of the jaw growth is finished.
Braces were placed at 15 years of age to place the teeth in their correct positions on the jaw bones. This often results in the teeth looking worse prior to jaw surgery. Then the jaws were surgical repositioned by moving the upper jaw forwards and the lower jaw backwards.