Deconstructing Oral Surgical and Orthodontic Considerations in Complex Cases: A Case Report on Two Patients With...

Management of multiple impacted teeth in nonsyndromic adolescents can be challenging, particularly when impactions involve several quadrants. This case report describes two adolescent patients with extensive impactions affecting both permanent and supernumerary teeth, with an emphasis on the clinical reasoning that guided treatment decisions. A quadrant-by-quadrant approach was used to determine when teeth were extracted, surgically exposed, or retained based on eruption potential, root development, and surgical access. Although the anatomical complexity of the cases was similar, treatment strategies differed according to individualized risk-benefit considerations. These cases highlight the value of structured clinical judgment in managing complex impactions without relying on rigid treatment algorithms.