Management of Maxillary Transverse Constriction & Dental Transposition Issues in Young Adolescent

With properly-timed mechanics and some ingenuity, good results can be achieved using the
orthodontic tools available to most dentists.

Orthodontic treatment of adolescent patients can be challenging due to developmental and genetic issues such as altered arch development variations and eruption patterns. These conditions can present situations where the tooth and skeletal arch relationships required for an acceptable and esthetically pleasing occlusion are altered, creating challenging dental and orthodontic issues.

Previous diagnosis or treatments of conditions may play into the management of the situation encountered. Tooth transposition is a unique and severe condition of ectopic eruption. It is defined as an interchange in the position of two permanent adjacent teeth located at the same quadrant in the dental arch. Transposition can be complete, when the position of affected teeth is totally transposed; or incomplete, when only the crowns are transposed, while the roots remain in normal position.1

Displacement and migration of teeth is a common phenomenon and literature evidence points to the fact that the maxillary canine is probably the most frequently displaced tooth. Sandham and Harvie conducted a study on Scottish school children and concluded that 0.38% were seen to have transposition occurring out of a sample of 800, which was corroborated by a study in India where the occurrence was seen to be 0.4%. Multi-factorial genetic factors,3 an interchange in the position of the developing dental lamina of the involved teeth and even trauma to the deciduous teeth in which dilacerations of the permanent incisor root was found. These have all been suggested as causes for transposition of teeth.

Another theory suggests that retained deciduous canines, observed in a large number of canine transpositions, might be the primary cause for the displacement and migration of the permanent canine from its normal path of eruption. Although not a true transposition, this migration theory may help to explain those extreme cases in which the canine erupted in the position of the incisor, second premolar or first molar.

With properly-timed mechanics and some ingenuity, good results can be achieved using theorthodontic tools available to most dentists.

Orthodontic treatment of adolescent patients can be challenging due to developmental and genetic issues such as altered arch development variations and eruption patterns. These conditions can present situations where the tooth and skeletal arch relationships required for an acceptable and esthetically pleasing occlusion are altered, creating challenging dental and orthodontic issues.

Previous diagnosis or treatments of conditions may play into the . . .

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