Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 30
Case Report
How would you treat this malocclusion?
Pre-Treatment
Case D.M. 20 years, 9 months
A video of this case can be found
at www.pcsortho.org.
An impacted central incisor should typically be
diagnosed in the mixed dentition, because maxillary central incisors normally erupt before the
canines, when a child is 8 to 10 years of age. The
prevalence of maxillary central incisor impaction
almost equals that of canine impaction, despite
their different etiologies. The main local factors
involved in this anomaly are supernumerary
teeth, odontomas, and trauma. The proper diagnosis and treatment of such impaction cases
requires the expertise of a team of clinicians
including a general practitioner, pediatric dentist,
orthodontist, oral surgeon, and periodontist.
This Case Report discusses the combined surgical
and orthodontic treatment of an adult patient
with an impacted upper left central incisor and
canine, shallow overbite, and reduced overjet.
Extraoral and Intraoral Findings
A 20-year-old African-American male presented
to the orthodontic clinic with a chief concern of
impacted permanent teeth, a retained primary
tooth, and occasional draining of pus from the
area. The patient reported good overall health
and no contraindications to dental treatment.
The initial clinical exam showed frontal symmetry and a convex profile with a 2 mm shift of the
upper dental midline to the left. The cephalogram showed some mentalis strain, but this was
not as evident clinically or in the photographs. No
TMD symptoms were noted. The patient vaguely
recalled a history of trauma to the front teeth
when he was very young, which could potentially
be a cause of or contributor to the multiple
impactions.
Initial photos
20 years, 9 months
30
PCSO Bulletin Summer 2017
http://www.pcsortho.org
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Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 2
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Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 30
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 31
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Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 50
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Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 57
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 58
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Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 73
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