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Concomitant permanent maxillary canine agenesis and transposition treated with extractions and lingual brackets

2020; Elsevier BV; Volume: 157; Issue: 4 Linguagem: Inglês

10.1016/j.ajodo.2018.12.026

1097-6752

Isabela Parsekian Martins, Renato Parsekian Martins, Graça Guimarães, Octavio Cintra, Ary dos Santos-Pinto,

Oral and Maxillofacial Pathology

•Maxillary canine-premolar transposition and canine hypodontia represent a significant clinical challenge. •The article discusses aspects of these conditions, including treatment planning and biomechanics, both involving a multidisciplinary approach. •This clinical case of transposition was successfully treated. This case report describes the successful orthodontic treatment for a healthy woman with maxillary canine-premolar transposition associated with rare hypodontia of the contralateral canine. The treatment included extraction of the transposed maxillary right and deciduous maxillary left canines and 2 mandibular second premolars. The objectives of the treatment were to (1) correct the upper midline deviation and the occlusal plane cant, (2) move the maxillary first premolars into the canine position, (3) retract the mandibular incisors to improve the facial profile, and (4) reduce the labial protrusion. Orthodontic treatment was carried out with the lingual technique in the maxillary arch and esthetic ceramic brackets in the mandibular arch. The segmented mechanics were effective, fast, and consistently promoted the necessary movement without side effects. The smile line was improved, resulting in an ideal and esthetic gingival exposition, with the borders of the maxillary teeth following the lower lip smile curvature. The patient achieved ideal dentofacial esthetics, achieved better dental and functional occlusion, was pleased with her improved facial contour, and as a result, showed an improved self-image. This case report describes the successful orthodontic treatment for a healthy woman with maxillary canine-premolar transposition associated with rare hypodontia of the contralateral canine. The treatment included extraction of the transposed maxillary right and deciduous maxillary left canines and 2 mandibular second premolars. The objectives of the treatment were to (1) correct the upper midline deviation and the occlusal plane cant, (2) move the maxillary first premolars into the canine position, (3) retract the mandibular incisors to improve the facial profile, and (4) reduce the labial protrusion. Orthodontic treatment was carried out with the lingual technique in the maxillary arch and esthetic ceramic brackets in the mandibular arch. The segmented mechanics were effective, fast, and consistently promoted the necessary movement without side effects. The smile line was improved, resulting in an ideal and esthetic gingival exposition, with the borders of the maxillary teeth following the lower lip smile curvature. The patient achieved ideal dentofacial esthetics, achieved better dental and functional occlusion, was pleased with her improved facial contour, and as a result, showed an improved self-image.