PMC6251235_01
Pre-treatment intra-oral photographs
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F1
The space at the upper right central incisor was reduced at 5.5 mm [Figure 1].
Pre-treatment lateral cephalogram, periapical and panoramic radiograph
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F2
The analysis of the lateral cephalometric radiograph confirmed a mild skeletal Class III relationship [Figure 2]. The panoramic radiograph demonstrated an impacted maxillary right central incisor and a submerged lower left deciduous second molar with a missing lower left second premolar successor [Figure 2].
Pre-treatment CBCT images
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F3
The crown of the tooth was displaced palatally with the root displaced labially and out of the alveolar housing as seen on the cone beam computed tomography (CBCT) [Figure 3]. The root length measured as the perpendicular distance from the cementoenamel junction to the apex of the root using the Simplant Pro 17.1 software is 8.2 mm [Figure 3].
Mid-treatment intra-oral photographs showing rectangular archwires to express palatal root torque on #11
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F4
Rectangular archwires with palatal root torque were placed to move #11 root palatally [Figure 4]. As the crown of the tooth was moved buccally, there was insufficient buccal cortical bone which resulted in a transient buccal recession as seen in Figure 4. The tooth also had prominent mammelons [Figure 4] and was extruded gradually to allow for enameloplasty of the incisal edges to improve the aesthetics and further helped to reduce the amount of buccal recession.
Post-treatment intra-oral photographs
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F5
The tooth had acceptable gingival contour with sufficient attached gingiva, hence no further soft tissue grafting procedures were indicated [Figure 5].
Post-treatment lateral cephalogram, periapical and panoramic radiographs
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F6
The crown of the tooth was positioned in its ideal position with respect to the contralateral central incisor [Figure 6], while the root of the dilacerated central incisor was positioned palatally [Figure 7]. On the periapical radiograph [Figure 6], the incisor reveals a shortened root due to the 90  crown-root angulation. The lack of buccal cortical bone on the apical aspect can be seen as a buccal defect on the intra-oral photographs in Figure 6.
Post-treatment CBCT
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F7
The crown of the tooth was positioned in its ideal position with respect to the contralateral central incisor [Figure 6], while the root of the dilacerated central incisor was positioned palatally [Figure 7]. The post-treatment CBCT [Figure 7] shows that there was mild root resorption of the dilacerated central incisor. The post-treatment root length measured as the perpendicular distance from the cementoenamel junction to the root apex using the Simplant Pro 17.1 software is 8.12 mm [Figure 7].