Stepwise traction approaches of impacted incisors in mixed dentition

• Published in: International dental journal Vol. 74; p. S356
• Main Authors: Torun, Çağla Kondoz, Koyuncu, Özge, Uğurlu, Faysal, Menteş, Ali
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-10-2024
• ISSN: 0020-6539
• DOI: 10.1016/j.identj.2024.07.453

Impacted upper incisors resulting from supernumerary teeth can pose aesthetic and orthodontic challenges. Here we presented two case reports with similar stepwise traction approaches for managing impacted upper incisors in mixed dentition.
Case 1: A 10-year-old female patient presented to Marmara University Department of Pediatric Dentistry with complaints of non-erupting upper incisors. Clinical examination and dental volumetric tomography revealed two impacted supernumerary teeth obstructing eruption of #11 and #21. Removable Hawley appliance with 2 hooks was designed before the operation. During surgery supernumerary teeth was removed, an attachment was bonded to each exposed impacted #11 and #21. Standardized closed eruption technique was applied, the ligature wire was tied to the hook of the Hawley appliance by the short chain elastics. The patient was scheduled every month until the teeth was erupted. Then fixed orthodontic appliances was placed at sixth month. Treatment was accomplished in seven months.
Case 2 involved a 10-year-old male patient with an over-retained #51 and asymmetric eruption of #21. DVT revealed an impacted supernumerary tooth obstructing eruption of #11. The case underwent a similar treatment protocol. After six months, impacted #11 became visible. Fixed orthodontic treatment was initiated and accomplished in 6 months.
The presence of supernumerary teeth increases the likelihood of impacted incisors, necessitating early diagnosis and appropriate intervention. Our experience highlights the efficacy of stepwise traction approach in mixed dentition due to the cooperation of the child.
Treatment of impacted upper incisors resulting from supernumerary teeth in mixed dentition varies from treatment approach for adults.