Multidisciplinary Orthodontic Management of Non-syndromic Delayed Tooth Eruption and Impacted Maxillary Canine...

Delayed eruption of multiple teeth in systemically healthy, non-syndromic adolescents represents a diagnostic and therapeutic challenge. When combined with impacted maxillary canines and vertical discrepancies, management becomes more complex. A 14-year-old healthy male presented with delayed eruption (DE) of multiple permanent teeth. Clinical and radiographic examination revealed bilateral DE of mandibular canines and both premolars, a unilateral impacted maxillary canine, and a severe deep bite. The patient had no relevant medical history and showed normal physical development. Orthodontic treatment included space creation for mandibular teeth, closed surgical exposure of maxillary canines, and traction of the impacted maxillary canines, piggyback arch mechanics for canine alignment, and occlusal plane levelling using auxiliary intrusion mechanics supported by a mini-implant for skeletal anchorage. During treatment, the patient sustained a traumatic mandibular fracture, which required management and temporarily interrupted orthodontic therapy, prolonging overall treatment time. Following fracture stabilization, orthodontic treatment was resumed and completed, resulting in satisfactory functional and aesthetic outcomes. This case highlights the complexity of managing non-syndromic delayed tooth eruption combined with impacted canines and a deep bite, particularly when complicated by traumatic injury. Careful biomechanical planning and multidisciplinary coordination are essential for achieving stable outcomes.