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Abstract

The orthodontic treatment of unilateral multiple impacted teeth is challenging. It is often accompanied with a wide range of surgical exposure for impacted teeth. We reported a 14-year-old male patient who had a retained primary canine, first and second molars in left maxilla, complicated with proximal caries and gingival abscess over the primary first molar. The panoramic radiography revealed with a horizontally impacted canine, first premolar and vertically impacted second premolar in left maxilla. After relive the underlined pathogenesis of the tooth impaction by removing the primary teeth and abscess, the second premolar erupted subsequently. During traction of the inferiorly impacted fist premolar, the superior horizontally impacted canine uprighted gradually and moved downward to the occlusion. The spontaneously intraosseous movement of the impacted canine allowed us to perform only gingvectomy instead of the aggressive wide surgical exposure. By preserving the integrity of periodontal ligament and Sharpey’s fiber, the highly impacted tooth might erupt spontaneously during the traction of the adjacent lower impacted tooth.

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