Early Traction For Impacted Teeth: A Case Report

This case report presented the treatment of a young girl with an impacted central incisor through closed orthodontic traction. Postoperatively, all four anterior teeth erupted and aligned properly, indicating the importance of early intervention. A 7-year-old girl presented with a complaint of an impacted upper left central incisor. In her mixed dentition stage, all four upper central incisors had not yet erupted. The CBCT view revealed that tooth 21 was horizontally impacted at a high position, with root development at stage 7 and insufficient eruption space, without root dilaceration, and tooth 22 tilted mesially. Treatment involved surgically exposing the palatal surface of the crown of tooth 21 and the labial surface of tooth 22, bonding attachments with chain and closed orthodontic traction teeth 21 and 22, along with open eruption spaces. Subsequently, a 2x4 fixed appliance was used to align the teeth. Postoperatively, optimal alignment, ideal periodontal health, and aesthetic outcomes were present. The treatment time was 24 months. Early traction for impacted teeth during the incomplete root development stage facilitates root growth and reduces treatment difficulty. Closed traction is beneficial for the periodontal health and aesthetics of the affected tooth. However, the treatment time trends toward being longer for high-positioned impacted teeth. Panoramic X-ray examination during the mixed dentition stage aids in the early detection of abnormal permanent tooth eruption. Early traction of impacted teeth promotes the health of the root and periodontal tissues. This case highlights the critical importance of early intervention.