Orthodontic Treatment of Unilateral Impacted Complete Transposed Maxillary Canine and Impacted Dilacerated Maxillary central incisor

Hakam Sabah,Omar Alluazy,Saba Al–Zubaidi

doi:10.33899/rden.2016.164140

Abstract

Aims: The purpose of this article was to present a case of surgical exposure and orthodontic reposition of impacted dilacerated maxillary left central incisor. Also surgical exposure of impacted maxillary left canine followed by orthodontic treatment of canine-lateral incisor complete transposition. result : this article describe the treatment of a teenager girl who had impactions of the maxillary left central incisor and canine as well as canine-lateral incisor transposition. The dilacerated impacted central incisor was uncovered and orthodonticaly extruded into the dental arch. Then the impacted canine was surgically exposed and orthodonticaly moving the tooth palately then distally to brought it into its normal position. Conclusion : concurrent impaction and transposition of maxillary anterior teeth is uncommon and poses a challenge for the dentist. Early diagnosis and management of eruption disturbances give us both esthetic and functional outcome benefits.

Highlights

A 0.022 inch slot stainless steel bracket was bonded on the labial surface of central incisor
Surgical exposure of palatally impacted canine was carried out and 0.022 inch slot stainless steel bracket bonded on its lingual surface
Among dentitional anomalies, tooth transposition is considered one of the most difficult to manage. Treatment option for these transposed teeth include alignment of teeth in their transposed positions, correction of the teeth to their normal position, and extraction of one or both transposed teeth.(12) Correction was not recommended for the teeth with complete transposition(13), few cases of correction of complete transposition have been reported. (14-16) Impaction of maxillary anterior teeth can be a challenging orthodontic problem

Summary

Orthodontic Treatment of a complete Transposed Impacted canine

Figure ( 1): (A): pretreatment periapical radiograph( B): Pretreatment panoramic radiograph. A 0.022 inch slot stainless steel bracket was bonded on the labial surface of central incisor. Surgical exposure of palatally impacted canine was carried out and 0.022 inch slot stainless steel bracket bonded on its lingual surface. Power chain elastic attached on the lingual bracket to move canine palataly toward the other side (right side) ( Figure 4 A and B), after the maxillary canine reached a position palatal enough to bypass the lateral incisor without damage and , 0.022 inch slot stainless steel bracket was bonded on the labial surface and power chain elastic attached to the bracket to move the canine bucally and distally (Figure 5 A and B). Post treatment panoramic and perapical radiographic finding shows normal position of the left maxillary centrallateral incisors and canine, class I molar relationship on both sides.

DISCUSSION

CONCLUSION