Nibia began treatment in 2008. She was initially brought for treatment by a congregation of nuns. This congregation paid for her initial treatment. However, they were unable to continue treatment and she was sent back to her home, 300 km from the treatment centre.

The patient’s parents work as labourers on a tea plantation. They could not afford to continue treatment. The Trust placed her in the home of a doctor’s family where she worked as a nanny and house maid. In exchange for her work, the couple paid for her treatment and helped her further her education.

Pretreatment: extra-oral frontal view

Pretreatment: intra-oral views

Plastic surgeon Dr. Vijay Joseph opined that surgical treatment was not ideal for this case. The treatment plan was thus to carry out bridge spanning of the entire upper arch.