PMC10202608_01
Pretreatment intraoral and extraoral photographs.
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Intraoral examination revealed Class I molar relationship bilaterally, Class I canine relationship on the left side, and retained right upper deciduous canine with diastema between the teeth in the right upper front region of jaw (Figure 1).
Pre-treatment study models.
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Pre-treatment radiographs. (a) Lateral cephalogram with tracing. (b) Occlusal radiograph. (c) orthopantomogram.
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Third molars were present in all the quadrants, and the overall alveolar bone level was within normal limits (Figure 3).
Bonding of brackets and insertion of 0.014'' NiTi archwire in upper arch.
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Initially, maxillary teeth were banded and bonded with fully programmed preadjusted 0.022 slot MBT prescription brackets (Figure 4).
Use of open coil spring for the creation of space.
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Wilcock, Whittlesea, VIC, Australia) was placed in the maxillary arch and enough space was opened using an open coil spring (Figure 5).
(a) Surgical exposure. (b) Bonding an attachment to impacted canine and central incisor. (c) Flap closure.
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Ligature wires with eyelets were tied to the bonded lingual buttons at one end, whereas the other ends were exposed in the desired position of the arch for orthodontic traction before the flap was sutured:a closed eruption technique was used (Figure 6).
CBCT images of the maxillary anterior region immediately after surgical exposure and attachment bonding: (a) Frontal image. (b) Sagittal image. (c) Coronal image. (d) Axial image. (e-h) Three-dimensional reconstructed images.
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There were no signs of resorption of the impacted and the adjacent teeth (Figure 7).
Mid-treatment photographs. (a) Use of 0.019'' x 0.025'' SS wire with v-notch just before surgical uncovering. (b) Hook soldered on the 0.019'' x 0.025'' SS wire to apply the force in a desired direction after bonding an attachment on the impacted teeth. (c) Retraction of upper right canine distally with the help of closed coil spring.
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Mid-treatment photographs. (a) Bonding of bracket on the upper right central incisor after its traction. (b) Application of individual labial root torque on 0.019'' x 0.025'' SS archwire in the region of upper right lateral incisor region. (c) Use of custom-made warren spring to achieve additional labial root torque (palatal crown torque) on upper right lateral incisor.
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(a-f) Treatment progress as changes seen in the maxillary occlusal photographs.
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Post-treatment extraoral and intraoral Photographs.
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Post-treatment study models.
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Post-treatment lateral cephalogram with tracing and orthopantomogram.
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The post-treatment radiographs (Figure 13) showed changes in the dental and skeletal parameters after the treatment.
Superimposition of pre-treatment (black line) and post-treatment (red line) cephalometric tracing.
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