Some questions about treatment for a patient with a dental anomaly pattern and ectopic teeth

Abstract

An article published in July 2020 by Massaro et al shows a case of an 8-year-old boy in the early mixed dentition with Class II, Division 2 malocclusion, and ectopic eruption of the mandibular right lateral incisor. (Massaro C, Janson G, Yatabe M, Calil L R, Marchini T O, Garib D. Dental anomaly pattern and multiple ectopic teeth. Am J Orthod Dentofacial Orthop 2020; 158:102-113). We appreciated the case report, but we have a few questions.1.The treatment progress (p. 105) starts with the extraction of deciduous mandibular right lateral incisor and canine, and after 8 months, a lingual arch with a hook distal to the right deciduous mandibular lateral incisor was installed. However, the hook seems to be placed on the right permanent lateral incisor and not deciduous (Fig 4, E). Moreover, Figure 4, F, was mentioned as a follow-up after mandibular right lateral incisor eruption, which should preferably be the follow-up for an eruption of permanent mandibular right canine.2.The superimposition of ANS-PNS at ANS shows that the mandibular incisor had retroclined posttreatment (p. 112, Fig 15. Initial [black], progress [red], and final [green] cephalometric tracings and superimpositions). In contrast, the table of cephalometric variables (p. 105) shows that mandibular incisor to NB increased from 17.8° to 25.1°, which suggests the proclination of the incisor. Therefore, the reading of the table and superimposition were contradictory.3.The table also shows the changes from the initial phase to after phase 1, in which SNA changes from 80.7° to 80.9° and SNB changes from 74.7° to 77.3°. This change depicts the correction of Class II malocclusion of the patient. However, the overjet shows a slight increase from 4.2 mm to 4.3 mm. The readings of the parameters do not follow each other. Finally, the table also shows the maxillary incisor to NA increases from 0.2 mm to 0.6 mm after phase 1, which depicts the proclination of incisors. However, the nasolabial angle shows the retroclination of the incisor as it increases from 102.1° to 115.5°. We would like to understand these variations. Dental anomaly pattern and multiple ectopic teethAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 158Issue 1PreviewTreatment for a patient with a dental anomaly pattern is challenging and complex. This article presents a rare case with an association of multiple ectopic eruptions treated in 2 phases. An 8-year-old boy in the early mixed dentition showed a Class II, Division 2 malocclusion, and an ectopic eruption of the mandibular right lateral incisor. The treatment plan included extractions of the deciduous mandibular right lateral incisor and canine, followed by partial mandibular fixed appliances and a lingual arch. Full-Text PDF Authors' responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 159Issue 1PreviewThank you for the nice initial comments; we appreciate the remarks. Full-Text PDF