RESUMEN
BACKGROUND: The extraction of an upper lateral incisor for orthodontic purposes is rare and must be adequately justified. AIM: The present case report describes the management of a skeletal Class II crowded malocclusion that was facilitated by the extraction of upper lateral incisors and lower first premolars. METHODS: A 14-year-old male patient presented with a skeletal Class II crowded malocclusion with associated speech and chewing difficulties. Phase I of treatment involved the extraction of the upper lateral incisors and functional appliance therapy. Phase II included the extraction of lower first premolars and mechanotherapy using full fixed appliances. RESULTS: An improvement in aesthetics and sagittal relations was achieved during phase I therapy as the mandible was advanced over a period of eight months. Mandibular skeletal change was 6.5 mm observed at pogonion. During phase II therapy, the maxillary canines were substituted for lateral incisors and a functional occlusion was achieved. The skeletal correction and occlusion were stable one year after debonding. CONCLUSION: The present case indicated that the timely extraction of palatally-placed maxillary lateral incisors facilitated functional appliance therapy in the management of a skeletal Class II problem. The crowding of the lower anterior teeth was relieved and alignment of the upper arch was achieved with full fixed appliance therapy, resulting in improved aesthetics and a stable occlusion at one year review.
Asunto(s)
Incisivo/cirugía , Maloclusión Clase II de Angle/terapia , Maxilar/patología , Extracción Dental/métodos , Adolescente , Diente Premolar/cirugía , Estética Dental , Estudios de Seguimiento , Humanos , Masculino , Mandíbula/patología , Avance Mandibular/métodos , Masticación/fisiología , Aparatos Ortodóncicos Funcionales , Planificación de Atención al Paciente , Retrognatismo/terapia , Habla/fisiología , Erupción Ectópica de Dientes/cirugía , Técnicas de Movimiento Dental/instrumentaciónRESUMEN
An impacted maxillary incisor in the early mixed dentition can pose a clinical challenge for orthodontists and pediatric dentists. Clinical observations supported with a 3-D imaging technique can help not only in assessing the precise location of the impacted tooth and its relation with neighboring teeth but also in correctly executing a treatment plan. The purpose of this paper is to describe the management of a severely rotated and horizontally impacted central incisor using intrabony rotation and simultaneous orthodontically-guided eruption. Timely intervention avoided disturbance in arch integrity and meticulous management helped to produce an excellent outcome in terms of function, esthetics, and stability of occlusion during two years of follow-up.