Maxillary canine premolar transposition is the most frequently reported transposition type, which many orthodontists face. Although correcting the transposed tooth order is not advised after the eruption of the permanent tooth, several articles published in the last decade demonstrated nonextraction treatment of transposition using fixed mechanics. This article describes the nonextraction treatment of a complete transposition between a maxillary left canine and a first premolar, using similar mechanics as suggested earlier. The correct tooth order was established with a functional Class I canine and molar relationship at the end of treatment. Although triangular cortical bone resorption at the vestibule of the canine root was detected on computed tomography at the end of treatment, spontaneous regeneration of bone tissue at the resorption area was present on the postretention computed tomography scan.
The shape of the cartilaginous septum, alar cartilage tip, medial and lateral crus and alveolar segments were molded to resemble the normal shape of these structures. ENMA can be helpful in any patient with unilateral cleft lip and palate because it is easy to fabricate, practical to activate, and comfortable to wear and use.
The pattern of expansion was rotation of the maxillary halves for SARME and lateral displacement of the dentoalveolar structures for NG-RME. Patients with severe skeletal discrepancy or increased age are good candidates for SARME.
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