Impaction of both maxillary central incisors and a canine

This case report describes the treatment of a 14-year-old adolescent patient who had 2 impacted maxillary central incisors with distoangular root dilacerations. He also had an impacted maxillary left canine, with the crown completely overlapping the root of the lateral incisor, and insufficient space. The general dentist referred this patient because the maxillary central incisors had still not erupted 2 years after extraction of the retained deciduous incisors. A unilateral expander with a modified vestibular arch and an attachment spring on the right side was used to correct the posterior crossbite on the right side and improve the positions of the teeth. The expansion appliance was also applied as a high anchorage device to move the central incisors and the left canine into position during the initial stages. After this phase, fixed appliances were used to redistribute the space in the anterior maxillary region to create enough space for repositioning the impacted teeth. This procedure restored the normal appearance of the maxillary arch, with good periodontal health and without evidence of root resorption, apart from the distoangular root dilacerations of the 2 maxillary central incisors.