Correcting the rotation of permanent central incisors with a coupling system: Case report

Abstract

Introduction: During the dental embryology period there is a possibility for morphological changes that affect the number, shape, eruption, size, and position of the teeth. There is a high incidence of supernumerary teeth among children, which can cause the dental organ to permanently rotate on its longitudinal axis. This is known as tooth rotation. To correct this alteration, the bibliography describes different treatment alternatives, including the coupling system. Objective: To describe the proper handling and treatment of tooth rotation in permanent teeth with a coupling system. Clinical Case: A 9 year-old, male patient arrives for a consult, he has a history of supernumerary dental organs around the upper incisors region (mesiodens), as a result of this, the two permanent upper central incisors have rotated. This can be observed clinically and radiographically. A plan using an active plate corrective treatment is designed for the rotation. An active plate with attachments is used to create a coupling system with parallel forces and slow rotation in order to preserve pulpal vitality and integrity. Results: The position of the upper central incisors is corrected and will be kept in observation. Conclusion: The treatment of tooth rotation with a coupling system and parallel forces is effective at an early age.