Tracionamento de incisivo central superior impactado com apoio em barra transpalatina modificada: relato de caso

Abstract

Impacted maxillary central incisor is a challenging condition for dentists, generally requiring a multidisciplinary approach. It can occur due to lack of space in the dental arch, primary or permanent successor dental alterations, presence of supernumerary teeth and/or associated pathological lesions, or due to a dense bony coating and excess local soft tissue. Careful planning and early intervention become essential to minimize esthetic and functional compromises, avoiding negative interference to the patient's psychological and social development. The main objective of this papper is report a clinical case of an upper incisor impaction caused by the presence of composite odontoma and prolonged retention of the deciduous tooth. As a collaborator, we had a 13-year-old male patient with esthetic discomfort in his smile due to prolonged retention of the deciduous upper incisor (51). Imaging exams identified impaction of the permanent upper central incisor (11), a suggestive image of compound odontoma, as well as agenesis of the permanent lateral superior incisors. In the first moment, an extraction of 51 and 53 was performed along with the excision of the compound odontoma, while awaiting spontaneous eruption of the 11. Faced with its incomplete eruption during the period of 6 months, the incisor traction was opted for with the aid of an orthodontic button and rubber bands supported in a modified transpalatal bar. After a year, the patient was found with the 11 erupted, awaiting fixed orthodontic treatment for correct dental alignment and leveling. The modified transpalatal bar was an alternative orthodontic for supporting the wire during the impacted permanent superior upper impacted in patients unable to use fixed orthodontic appliances.