Canine-lateral incisor transposition: Controlling root resorption with a bone-anchored T-loop retraction

Area of Science:

• Orthodontics
• Dentofacial Orthopedics
• Dentalomechanics

Background:

• Class II Division 1 malocclusion presents common challenges in pediatric dentistry.
• Canine transposition, particularly in the maxillary arch, complicates standard orthodontic treatment protocols.
• Effective management requires precise biomechanical strategies to address root and crown positioning.

Observation:

• A 12-year-old female exhibited a Class II Division 1 malocclusion with complete transposition of the maxillary left canine.
• The canine occupied the space of the maxillary left lateral incisor, necessitating a non-standard approach.
• Conventional bracket engagement was modified, excluding the transposed canine initially.

Findings:

• A novel approach utilizing a stainless steel miniscrew in the infrazygomatic crest anchored a T-loop archwire.
• This system facilitated the retraction of the canine root over the distally positioned lateral incisor root.
• The treatment duration was 24 months, resolving a severe malocclusion (Discrepancy Index 18 to Cast-Radiograph Evaluation 26).

Implications:

• Miniscrew-supported T-loop mechanics offer a viable solution for complex canine transposition cases.
• This technique allows for controlled root movement and efficient space management in challenging malocclusions.
• Successful treatment highlights the importance of advanced biomechanical options in orthodontics for improved patient outcomes.