PMC7350164_01
Pretreatment photograph showing wide diastema median, anteriorly positioned tooth 21, palatally malposition tooth 22, and gingiva recession of tooth 31 due to traumatic occlusion from the extracted supernumerary tooth.
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Tooth 22 was in crossbite to the left mandibular permanent lateral incisor (tooth 32) and permanent canine (tooth 33) (Figure 1).
Sectional orthodontic wire appliance to guide tooth 21 into arch alignment through deflection technique.
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It took over 4 months to achieve the desired result (Figure 2).
A 2 x 4 orthodontic appliance to guide malpositioned tooth 22 into arch alignment.
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Initially, we used a 012 round NiTi orthodontic arch wire to bring tooth 22 into alignment (Figure 3).
Tooth 21 and tooth 22 brought into acceptable arch alignment and the severity of gingiva recession of tooth 31 reducing.
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After four months, we brought tooth 22 anteriorly over teeth 32 and 33 into alignment (Figure 4).
PMC7350164_02
Malposition and rotate tooth 12 palatal to tooth 11.
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On examination, tooth 12 was found to be palatal to tooth 11, rotated, and in a crossbite to the lower incisors (Figure 5).
Sectional orthodontic wire appliance used to rotate and bring tooth 22 anteriorly into arch alignment.
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The free end of the 012 NiTi wire on the right side was attached to the tip of the erupting right maxillary permanent canine (tooth 13) with composite resin (Figure 6).
A 2 x 4 orthodontic appliance used to bring all permanent upper incisor into arch alignment.
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We replaced the sectional orthodontic wire appliance with the 2 x 4 orthodontic appliance once two-third of the crowns of the premolar and canine clinically seen (Figure 7).
Six months posttreatment photograph: patient's upper incisors in an acceptable arch alignment.
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The process of bringing the rotated tooth 12 into arch alignment took us close to 7 months (Figure 8).