case_images: PMC10882190_01
case_images: (A) Occlusal view of the maxillary arch and mandibular arch, (B) left occlusal view, (C) front occlusal view, (D) right occlusal view
case_images: cureus-0016-00000052762-i01.jpg
case_images: PMC10882190_01_cureus-0016-00000052762-i01.jpg
case_images: FIG1
case_images: Upon intraoral examination (Figure 1), the patient's dentition showed proclination in the anterior region with the absence of the upper central incisor.
case_images: OPG Showing supernumerary teeth along with impacted central incisor in the upper right quadrant. OPG: Orthopantomogram
case_images: cureus-0016-00000052762-i02.jpg
case_images: PMC10882190_01_cureus-0016-00000052762-i02.jpg
case_images: FIG2
case_images: The radiographs revealed that the impacted central incisor was positioned vertically within the maxillary bone, hindering its natural eruption (Figure 2).
case_images: (A) CBCT Image showing supernumerary teeth with the impacted central incisor in blue arrow on axial view (B) Panoramic view showing the distance of the impacted central incisor from the alveolar crest. CBCT: Cone-beam CT
case_images: cureus-0016-00000052762-i03.jpg
case_images: PMC10882190_01_cureus-0016-00000052762-i03.jpg
case_images: FIG3
case_images: It was surrounded by a thick layer of soft tissue and oriented vertically in the cone-beam CT (CBCT) scan (Figure 3).
case_images: (A) Buccal flap raised to expose supernumerary teeth, (B) after removal of supernumerary tooth, a surgical exposure of the facial surface of the central incisor was done, (C) loose suture given to secure the flap, (D) image after seven days of healing
case_images: cureus-0016-00000052762-i04.jpg
case_images: PMC10882190_01_cureus-0016-00000052762-i04.jpg
case_images: FIG4
case_images: Traction force was applied to the impacted central incisor using a piggyback 0.016NiTi round wire, and a 0.016*0.022 stainless steel wire was the base archwire; also, teeth were consolidated with a ligature wire (Figure 4).
case_images: PMC10882190_02
case_images: (A) After the exposure of the impacted central incisor, (B) lingual button attachment for traction, (C) complete disimpaction of the central incisor, (D) uprighting of teeth
case_images: cureus-0016-00000052762-i05.jpg
case_images: PMC10882190_02_cureus-0016-00000052762-i05.jpg
case_images: FIG5
case_images: The patient had now entered the finishing and detailing stage of the orthodontic process (Figure 5).