Digital Laser-Sintered Expander in Adolescent Patient with Hyperdontia and Molar Impaction

Area of Science:

• Dentistry
• Orthodontics
• Oral Surgery

Background:

• Supernumerary teeth, including paramolars, present unique diagnostic and treatment challenges in orthodontics.
• Impacted supernumerary teeth can lead to abnormal alveolar bone development and malocclusion, such as open bite and crossbite.

Observation:

• A 16-year-old female presented with an anterior open bite, bilateral posterior crossbite, a supernumerary paramolar, and impacted upper molars.
• The supernumerary paramolar contributed to asymmetric maxillary alveolar bone growth, impacting overall jaw development.

Findings:

• A combined surgical-orthodontic approach, including extraction of the supernumerary paramolar and impacted teeth, was employed.
• A 3D-printed rapid maxillary expansion appliance facilitated transverse correction, with a distal extension aiding orthodontic traction of a second molar.
• Surgical intervention and maxillary expansion successfully stimulated molar eruption, normalized alveolar bone height, and corrected the occlusion.

Implications:

• This case highlights the effectiveness of integrated surgical and orthodontic management for complex supernumerary tooth cases.
• Early diagnosis and individualized treatment are crucial for managing supernumerary teeth and achieving optimal occlusal outcomes.
• Paramolars often remain impacted, necessitating careful evaluation and treatment planning.