Objective: While impaction of a tooth is considerably common, impaction of multiple teeth is a rare occasion and may be related with syndromes or metabolic disorders. In some cases, however, impaction of multiple teeth is not accompanied by any symptoms. The aim of this case report is to present the treatment approach performed in a non syndromic patient with six impacted teeth in mandible.
Methods: A 15 year-old male patient was referred to our clinic for impacted canines and incisors in mandible. In his medical and family history, no signicifant findings existed about multiple impaction. Clinical and intraoral examination showed Class II subdivision malocclusion. He had a complete overbite with retroclined upper incisors. Cephalometric evaluation revealed Class I skeletal pattern with hyperdivergent tendency. Panoramic radiography indicated that impacted right and left mandibular canine blocked the eruption of all lower incisors. Following lower deciduous canines and incisors extraction, upper and lower arches were levelled. After surgical exposure of impacted canines, cleat with Ni-Ti coil springs were bonded and ortodontic traction was performed.
Results: Forced eruption of canines reduced the pressure on incisors and they erupted stimultaneously. Eventually all impacted teeth were erupted at the end of 8 months.
Conclusions: Favorable facial esthetic and Class I molar relationship with a fuctional occlusion were established at the end of the treatment. To achieve optimum function and esthetics, an interdisciplinary approach between orthodontist and oral surgeon is essential in the treatment of impacted teeth.