No abstract

Introduction: Several orthodontic problems should already be treated at an early age to prevent the necessity of future complex and expensive procedures. Scientific evidence suggests that posterior crossbites, mild to moderate Class III, as well as certain Class II malocclusions, open bites and arch length discrepancies can benefit from simple, but efficient interceptive therapy. Objective: To summarize the existing evidence-based literature on early orthodontic treatment, and to illustrate its application and effectiveness by showcasing multiple clinical examples. Conclusion: Early short-term interceptive orthodontic treatment with simple appliances, in the deciduous or early mixed dentition phase, can efficiently correct certain malocclusions and help to either reduce the complexity or even avoid the necessity of complex and expensive procedures during puberty. For certain patients with significant arch length discrepancy the concept of serial extractions should be part of the orthodontic armamentarium.

We report the successful orthodontic treatment of a 13-year-old girl who had been involved in an accident with avulsion of her maxillary right central incisor and both mandibular left incisors. Fifteen months after replantation of the teeth, all showed severe root resorption with apical inflammation and had to be extracted. After compensatory removal of the maxillary left central incisor, all 4 extraction sites were closed within 20 months of active orthodontic treatment to avoid implant-prosthodontic replacement. By sequential extraction of the 2 hopeless replanted equilateral mandibular left incisors and common-sense management of straightwire mechanics, it was possible to move the right central incisor across the mandibular midline and close the large space completely. To our knowledge, no case report about orthodontic closure of 2 adjacent extraction spaces in the same quadrant has been published.