Transposed Teeth

I first saw this patient when she was 8 years old. She had a severe amount of upper and lower crowding, with narrow arch forms.

She had a first phase of treatment with an upper Transverse appliance and a lower lip bumper to develop her arch forms and create space (I do not have good records of this phase, so they are not pictured here). This phase created enough net space to fit all of the permanent teeth in. However, the lower left canine and lateral incisor came in transposed:

Because it appeared that there was enough separation between the roots of the transposed teeth that they could be moved around each other without either periodontal damage or root damage, I recommended that the transposition be corrected.

The red arrows show the direction of movements necessary to correct the transposition. The teeth on her left were moved into the leeway space on her left, and the teeth to her right of the blocked out lateral incisor were moved into the leeway space on her right.

Start of treatment with braces
End of treatment

End of Treatment radiographs:

Notice the parallelism of the roots and normal root lengths (the roots of all of the lower incisors look slightly short because they were out of the focal trough of the panorex).

After the braces were removed, I referred her to an Oral Surgeon to have the wisdom teeth evaluated for removal since they did not have enough room to erupt.

Her total treatment time was about 6 and a half years betwteen the start of the first phase until her braces were removed. She was in braces for 3 years and 7 months (a good part of that was spent waiting for her upper second molars to erupt so that I could align them).

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