Maintain the over-retained 75 long-term. Extract the
infraoccluded 85 and the impacted 18,28,38,48. Attempt orthodontic
alignment of the impacted 45 in conjunction with comprehensive
orthodontic fixed appliance treatment.
- Rapid maxillary expansion (RME) to address the maxillary transverse
deficiency and correct the LHS posterior lingual crossbite
- Surgical exposure and subsequent orthodontic traction with a gold
chain to disimpact the 45 is likely to be both prolonged and
challenging. The 45 may also be significantly damaged during removal
of the ankylosed 85
- Maintaining the 75 is clinically justifiable as this tooth is
structurally sound and demonstrates no evidence of infraocclusion or
mobility. Upon its eventual clinical failure, a restorative implant
can be placed in this region