Orthodontic management of ectopic and impacted teeth

Ectopic eruptions manifest in diverse clinical scenarios with varying severity. Sometimes, monitoring eruption alterations allows for early intervention and simpler treatments. Interceptive approaches, such as removing obstructions or creating space, can prevent more complex and invasive procedures. However, when simple measures like supernumerary removal, space gaining, or deciduous tooth extraction fail, surgical-orthodontic interventions are necessary to address dental impactions stemming from eruption abnormalities. Impactions often require more complex treatments. This comprehensive review covers ectopic eruptions and impactions of all teeth, from maxillary incisors to mandibular second molars, detailing both interceptive and corrective strategies. It emphasizes clinical evaluation and contemporary imaging while thoroughly explaining mucogingival considerations and orthodontic biomechanics. Different approaches to impactions in the orthodontic treatment, such as open and closed eruption, Gopex, miniscrews as an anchorage, and alternative case-based protocols are described. Complications and solutions for dental impactions are illustrated tooth by tooth, providing practical guidance for managing these common clinical challenges.