ORTHODONTICS: Bilaterally U2-U3 Transposition in Early mixed Dentitons

Maxillary lateral incisor-canine transposition is extraordinarily problematic for aesthetics and function, since the lateral incisor is slimmer and shorter to bear the occlusal force and perceptive appearance of the canine.

Prompting orthodontic treatment after a transposed canine has totally erupted reveals the complexity of treatment mechanics, the risk of root resorption, buccal bone recession, and serious compromises with false tooth sequence. This article discusses how to reverse the bilateral interchanges of the positions of two adjacent teeth without permanent tooth extraction, foster the arch expansion with a partially fixed appliance without bonding brackets on the lateral incisors, resulting in the maxillary canines drifting to their sequences before complete eruption. However, the expansion for increasing arch length also increased the overjet by more than 7mm. In this interceptive treatment, Class II elastics and the advanced growth of the mandible were anticipated to reduce the overjet discrepancy at the age of puberty. After three years of follow up after the treatment had been completed, the occlusion was very stable, while the overjet discrepancy never relapsed.


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