Orthodontic treatment for an adolescent with a history of acute lymphoblastic leukemia

This case report describes the treatment of a Class I malocclusion that involved ectopic position of the maxillary permanent left canine and the mandibular permanent right second molar. The patient was an adolescent who presented with a medical history that was remarkable for diagnosis and treatment of acute lymphoblastic leukemia (ALL). Dental history was remarkable for significant, generalized shortened roots that were more severe in the mandibular arch. The treatment included fixed appliance therapy in the maxillary arch only and surgical luxation of the mandibular second molar. Successful integration of the maxillary permanent left canine was accomplished without excessive flaring of the maxillary permanent incisors or disruption of the buccal segment occlusion. The risk of external root resorption on teeth with abnormal root morphology, as a result of fixed appliance therapy, should be weighed against the relative benefits that are expected from treatment.