Orthodontic traction of impacted upper central incisors related to mesiodens

Although maxillary central incisors impaction is not a high frequent clinical condition, it is responsible for some undesirable aspects of patients smile from esthetic and functional points of view. There are some etiologic factors associated to this dental disturbance but the scientific literature is consensual on determining the importance of the early diagnosis and proper intervention. This manuscript consists on the case report of a 10 years old boy with Class I malocclusion, who showed during the mixed dentition phase, impaction of maxillary central incisors related to deciduous teeth retention and due to the presence of 2 mesiodens. The treatment proposed involved the surgical removal of the mesiodens, bonding of orthodontic accessories to the impacted incisors crowns followed by orthodontic traction with a removable orthodontic appliance. Regardless the development stage of the dentition was not ideal for this intervention, once the diagnosis should have been done as earlier as possible, favorable esthetic and functional results were attained.