Orthodontic movement of a contralateral maxillary central incisor across the midpalatal suture

Abstract

There are several options for replacing a missing maxillary central incisor in orthodontic treatment. Substituting a missing central incisor with the contralateral one can be a useful approach to reduce the number of teeth that require extraction during the treatment. Normal tooth movement across an ossified midpalatal suture (MPS) has only been observed in an animal experiment. Herein, we describe the treatment of a 26-year-old woman who had lost multiple teeth on one side, including the maxillary right central incisor, which required extraction due to endodontic failure. The maxillary left central incisor was moved into the position of the maxillary right central incisor. All other left maxillary teeth were moved mesially to close the space. After completion of orthodontic treatment, acrylic build-up was performed on the maxillary left lateral incisor, which underwent morphological modification to replicate the morphology of a maxillary right incisor. The patient was pleased with the treatment outcome. Cone-beam computed tomography provided evidence of tooth movement across the MPS. Although the movement of the tooth across the MPS is feasible, the treatment plan should also take other treatment options into consideration.