ABSTRACT
Background: Crowding, rotation and impaction of teeth are some of the complications of supernumeraries. This
article aims to discuss the orthodontic treatment of a severely rotated upper left central incisor (UL1) secondary
to an erupted mesiodens. An 18-year old Malay male presented with Class I malocclusion with severely crowded
upper arch, presence of erupted mesiodens, severely rotated upper left central incisor, displaced upper left lateral
incisor and upper left canine and centreline discrepancy. Methods: He had a combination of segmented arch
and couple force mechanics to correct severely rotated central incisors. Following anchorage reinforcement, the
upper mesiodens and the upper right first premolar was extracted. Subsequently, treatment was continued with
conventional straight wire mechanics. Results: The severely rotated upper left central incisor was successfully
corrected, and the upper arch crowding was resolved. The fixed appliances were debonded and he was provided
with upper dual retention. He had gingival recession Type 1 at UL2 due to the bony defect. Conclusion: Severe
crowding can be managed with segmented arch mechanics without any detrimental effects using low forces and
good planning. Further periodontal consultation and management were required for the treatment of UL2.
ABSTRACT
Aim: To describe the distribution and association of dental and occlusal anomalies to gender in children of mixed
and early permanent dentition. Methods: It is a cross-sectional study with stratified random sampling based on the
main ethnic composition involving 413 subjects aged between 9 and 11 years old enrolled in 7 national primary
schools in Sungai Buloh, Selangor. A calibrated operator carried out clinical examinations, and study models
were fabricated. All dental and occlusal anomalies were recorded accordingly and were analysed using SPSS
version 21.0. Pearson chi-square test was used to determine the gender-based differences for various parameters.
Results: The reported dental anomalies were supernumeraries and clinically missing teeth (impacted or
hypodontia) with a prevalence of 1.5% and 6.3%, respectively. The occlusal abnormalities were: crowding
(54.0%), sagittal discrepancies (overjet; increased, reduced, and reversed overjet: 55.5%), vertical discrepancies
(overbite; increased, reduced, and open bite: 37.5%) and transverse discrepancies (unilateral and bilateral
posterior crossbite: 5.1%). Gender-based differences were not statistically significant to all reported dental and
occlusal anomalies (p>0.05). Conclusions: Children in the mixed and early permanent dentition showed various
dental and occlusal anomalies with crowding being the highest anomaly. Gender was not associated with any
type of dental or occlusal characteristics in the studied population.