Delayed formation of multiple supernumerary teeth

Multiple supernumerary teeth in either the maxillary anterior or premolar region can cause uneruption or impaction of the succedaneous permanent teeth. Supernumerary premolars are special in terms of their late development and recurrence. This case report details the use of multiple phases of orthodontic traction in order to obtain ideal clinical results. An 8-year 4-month-old healthy boy had an impacted left upper central incisor and multiple supernumerary teeth among the incisors and premolars. The impacted incisor was successfully moved to its proper position by orthodontic traction and a closed eruption technique. One year later, surgical extraction of three supernumerary premolars was performed. The same traction procedure with the closed eruption technique was successfully used to pull the mandibular left first premolar into its occlusion. A normal appearance of the anterior teeth and posterior occlusion were achieved after two phases of orthodontic traction. The exposed incisor and premolar presented a proper gingival contour and acceptable attached gingiva. Multiple supernumerary teeth can cause multiple sites of unerupted permanent teeth that make the treatment procedures variable and complicated. The impacted teeth can be moved to their proper position by multiple phases of orthodontic traction and a closed eruption technique