Severely Rotated Single Rooted Teeth: Etiology, Treatment, and Orthodontic Adjuncts Review

Fixed orthodontic treatment of the adult dentition most often begins with the progressive series of arch-wires to obtain leveling, alignment, and alleviate rotations within the dentition. This initial phase sequence of events is oftentimes routine as the properties of nickel titanium archwires and bracket placement are expressed. However, challenges can arise early in treatment plans that inhibit a smooth transition amongst the level, alignment, and rotation (LAR) phase of treatment.

One common treatment progression challenge is the presence of one or more severely rotated teeth that are so far out of alignment that typical bracket placement and archwire engagement are impossible. This review will identify teeth that most commonly have severe rotations, various treatment modalities to efficiently correct the rotations, and highlight products and adjuncts to successfully achieve de-rotation of severely rotated teeth.