Solving the Puzzle: Multiple Anterior Impacted Teeth and the Proper Mechanics Needed to Achieve Desired Results in Adolescents

Dental and orthodontic treatment of adolescent patients can be challenging due to altered dentition caused by eruption variations and anomalies and altered dental development. These conditions can present a situation where the teeth required for an acceptable and esthetically pleasing occlusion are altered or absent creating challenging dental and orthodontic issues. The authors will present a case report of an adolescent patient with ectopic eruption pattern of the right maxillary canine (#6), impaction of lateral incisor (#7), and central incisor (#8).

The case report is interesting because it presented a young adolescent with delayed eruption of #6 (right maxillary canine), impacted #7 and #8 (lateral and central maxillary incisors), bi-protrusion of maxillary arches, multiple diastemas on maxillary mandibular arches, Class I molar dentition on both sides, and Class II canine dentition of the left side. The high priority objectives in this case were preserving the maxillary cant, reducing the bi-maxillary protrusion, and bringing the delayed and impacted teeth into the arch.

The report will describe (1) how each tooth was affected during treatment, (2) how the requirements for special anchorage were handled to allow for better control of the overall situation, and (3) how to avoid the side effects of anchorage teeth intrusion while moving impacted teeth into their proper arch position. By presenting this case report, the authors believe that the readers may increase their understanding of altered dental anatomy, occlusion development, and controlled skeletal anchorage for its use in orthodontics.

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