By Andrey Horton, DDS rch stabilization is essential to prevent unwanted movements during orthodontic eruption of impacted teeth. This is espe-cially pertinent during treatment when dealing with more than one impacted tooth. Adequate space and arch development are necessary A for completion of any normal orthodontic treatment. Proper finishing mechanics from incorpo-rating impacted tooth eruptions can be challenging to accomplish. Several factors must be consid-ered when initializing treatment dealing with tooth impactions. Fig. 1 What was the cause of the impaction if any? Is there still potentially a digit or tongue habit perpetuating the current patient presentation? Are there factors that are contributing to the condition from ectopic eruptions, to ondonto-genic obstructions like a mesodens, or some type of compound or complex ondontomas? According to Proffitt, a localized problem is typically created either by displacement of a permanent tooth from its normal eruption path so that the tooth becomes impacted (usually the maxillary canine: or by trauma that leads to ankylosis.) 1 One must consider all potential outcomes of attempting treatment including analyzing the degree of displacement and other factors. Arch anchorage and stability are key to minimizing unwanted tooth movements. CLINICAL ANALYSIS In this particular case, a healthy 15-year-old Latin female, L.G., presented to my office with a chief complaint of an anterior open bite and anterior flaring of the maxillary incisors. (Fig. 1) The patient exam revealed a Class I molar and skeletal relationship with an anterior open bite and a left side posterior cross bite. There was also a cross bite asso-ciated with her primary tooth "C." L.G. had a high-vaulted palate and a slight cant due to a previous digit habit that had been resolved for several years. The lower incisors were retroclined due to the previous digit habit. RADIOGRAPHIC ANALYSIS Fig. 2 At the age of 14 years and 11 months, L.G. presented to my office with primary teeth C, G, H, & I still 16 Winter 2023 JAOS
Journal of the American Orthodontic Society Winter 2023: Page 16
