Preventive dental and orthodontic approach to transposition. A case report

Aim: The goal of this work is to briefly present teeth transposition and describe a successfully solved case in “Sapienza” University of Rome, U.O.C. Pediatric Dentistry. Tooth transposition is a severe positional anomaly, affecting 0.4 % of the population, that may create many orthodontic problems from both esthetic and functional points of view. Dental transposition is defined as the positional interchange of two adjacent teeth or the development or eruption of a tooth in a position normally occupied by a non-adjacent tooth. The maxillary canine is the most commonly involved teeth in the transposition, changing its eruptive place with the lateral incisor or the first premolar in most cases. In such canine transposition the treatment options may include alignment of the teeth in their transposed positions, extractions of one of transposed teeth, orthodontic movement into the correct position in the arch. The treatment options was decided with careful consideration of the multiple clinical variables: stages of development and position of root apices, facial esthetics, dental morphology, occusal consideration, treatment time, age and compliance of the patient. Methods: Many publications reporting people with maxillary tooth transpositions were examined from word-wide sources. This paper presents a case report demonstrating the preventive orthodontic management of a mandibular transposition in a girl 9 aged years. The panoramic radiograph of the early mixed dentition, is a very useful source for detecting the presence and position of the unerupted permanent teeth. The best time to begin assessing a child for potential tooth transposition is the early mixed dentition period, around the age 6 to 8 years. In this case panoramic showed an incomplete mandibular lateral incisor-canine tooth transposition which caused lack resorption 8.3 and eruptive obstacle of 4.3 and 4.4. Results: Early interceptive procedure has provided the pleacement of a lingual arch to preserve arch length, followed by the extraction of the deciduous tooth, and pleacement of eruption guider for the permanent teeth, thus preventing complete development of the anomaly. This allowed teeth to became upright and erupt into its proper position in the arch. Conclusions: Transposition of teeth in an uncommon dental anomaly. The interceptive treatment of the transposition in the early mixed dentition of pedodontic patient simplified the corrective orthodontic treatment, making it faster and less complex, how to cited in others studies.