ABSTRACT
Dental fluorosis is a condition of enamel hypo-mineralization due to the effects of excessive fluoride on ameloblasts during enamel formation. Bonding brackets to fluorosed teeth remains a notable clinical challenge because of frequent bracket failure at the compromised enamel interface. This case report presents comprehensive management of an adult patient with Angle’s class II div 1 malocclusion with crowding and severe dental fluorosis. Diagnosis: A diagnosis of severe dental flourosis was established based on Deans‘s index for fluorosis (score-3) with a skeletal Class I pattern and Angle’ s Class II Division I dental malocclusion with upper anterior crowding . Treatment plan: Orthodontic treatment with extraction of upper first premolars to correct the dental malocclusion followed by restorative procedure. Treatment results: Competent lips achieved after orthodontic treatment. A class-II molar relation was maintained .Excellent dental esthetics was seen after direct composite restoration.