In the mutilated case in adults, generally malocclusion is often accompanied by less support of periodontal tissues, such as alveolar bone resorption and gingival resession. The treatment of orthodontic is to arrange the teeth into good position and good occlusion, but is widely known to increase the alveolar bone resorption. In handling such case, ortodontist needs to look at factors which do not increase exixting alveolar bone resorption and gingival resession. In this case report, it will be reported orthodontic treatment on mutilated case which are accompanied by alveolar bone resorption and gingival resesion on a patient of 45 years and 4 months of age.