Maintain the over-retained 75 long-term. Extract the
infraoccluded 85, impacted 45 and 18,28,38. Comprehensive orthodontic
fixed appliance treatment including effective mandibular molar
mesialisation on the right side
- Rapid maxillary expansion (RME) to address the maxillary transverse
deficiency and correct the LHS posterior lingual crossbite
- Removing the 85 and 45 will create an alveolar bony defect which can
be regenerated with normal healing and TAD-assisted mesialisation of
the 46,47. Effective mesialisation will also create space for the
unerupted 48
- 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. This represents simpler orthodontic
treatment in the 3rd quadrant
- Review the unerupted 48 until its expected eventual clinical eruption
and the over-retained 75 for any structural integrity issues