Introduction: Eruption of central incisors occurs at a time when the mixed dentition starts to develop and their impaction is mostly a severe esthetic problem. Aim: Our aim was to assess the frequency of impaction of an upper central incisor and to analyse the factors which affect the successful outcome and the protocols for orthodontic treatment in cases of impacted upper central incisors. Materials and methods: In the present study, we used all medical records of 651 patients treated in our private practice over the last 3 years and also the medical records of 18 patients we diagnosed and treated for this problem over the last 8 years. Results: We found the ratio of impacted upper central incisors to be 1.4% as there were more male than female patients affected. There were 2.8% male patients and 0.7% female patients. The most frequent cause of impaction of the upper central incisor was the presence of mesiodentes and supernumerary teeth (55.5%), followed by presence of follicular cysts (44.4%) and odontoma collections (22.2%) or a combination of these.Several approaches have been used in treating the different positions of impacted incisors. It is necessary first to rotate the axle of the incisor and assure its root full bone coverage. We used directly TPA for support. In other patients, we waited for the spontaneous eruption after removal of the etiological factor and in another patient, we used conventional fixed techniques. Conclusions: It is important that dental doctors should monitor the formation of the dentition so that they detect the impacted tooth early in its development.

In interceptive treatments in which impacted teeth (incisor or first permanent molar) should be included into the dental arch, the main clinical problem is the provision of an anchorage area and a suitable appliance. The use of a laser-sintered metal orthodontic printed dento-alveolar anchorage (PDaA), designed and printed digitally, has expanded the boundaries of orthodontic treatment, especially in its interceptive phase. Our aim is to describe a laser-sintered metal appliance to provide anchorage during orthodontic surgical traction of impacted teeth in the mixed dentition period. The presented clinical cases were treated with digitally projected and printed metal PDaA. In the described clinical cases, individually designed anchorage systems were used. They were created through design software and, after that, the metal appliances were printed. The devices were placed in the oral area and did not disturb the aesthetics of the patient. The advantages of individual designed metal PDaA allow the accommodation of the morphology of the hard palate and alveolar bone. This makes the PDaA comfortable for the patient and rigid enough to perform orthodontic traction at the same time. The PDaA is applicable in mixed dentition and, in complicated clinical cases, in permanent dentition. Their individuality allows for segmental treatments or treatments in cases requiring additional anchorage further away from the active force.

Background: Compound odontoma (CpOD) develops tooth germ-like structures but often lacks complete differentiation. Some authors recognize the compound odontoma as supernumerary teeth. Objective: This study aimed to present the analysis of orthodontic problems and radiological findings in three clinical cases of patients with complex odontoma. Case Presentation: The present three clinical cases of patients (two females and a male), aged from 14 to 25 years, had compound odontoma, which was confirmed through their radiological findings. Patients did not report symptoms associated with pain and discomfort in the area or genetic predisposition in the family. Orthodontists examined each clinical case with its individual problems and solutions. The findings were localized in the canine region, in 2 of the cases in the upper jaw and one in the lower. Only one patient with localization of the problem in the lower jaw had no disturbance in the eruption of the teeth in the affected dental arch, while in two patients with localization of the problem in the upper jaw, retention of permanent canines was found. In all three cases of the odontoma, there was one tooth with the reverse direction of the crown root. In one case, a supernumerary tooth near the odontoma was also observed. In all of the presented cases involving compound odontoma, there was one main well-formed and developed tooth, around which the other tooth-like structures were located, usually with a conical shape. Conclusion: CBCT contributes to establishing an accurate and detailed morphological characterization of the fundamental structures (teeth) in the odontoma.

High technologies are applicable in orthodontics at every stage: diagnosis, treatment planning, design and production of treatment devices; patient file storage; constant performance analysis and development forecast. Innovative technologies allow analysis of the virtual patient to recreate good clinical results in the real patient. Our article describes the application and effectiveness of software for the design and manufacture of orthodontic appliances. Validate diagnostic data and results by overlaying data from different software.

In the process of odontogenesis, a disturbance in the formation of the epithelium and mesenchyme can be observed and this can be manifested by atypical forms of dental development. Such biological phenomena with altered morphology are as follows: dens invaginatus (DI), dens evaginatus (DE), talon cusps, and double teeth (DT) or connate teeth (fusion and gemination). Patients with orthodontic anomalies who also exhibit teeth with morphogenetic disorders are presented in this article. Dens evaginatus and talon cusps pose orthodontic challenges in the treatment finishing phase. These reduce the possibility of achieving maximum intercuspidation between the lower and upper front teeth as well as poor incisor guidance. Other orthodontic challenges are as follows: the risk of occlusal trauma and periodontal loading of the antagonists and the possibility of accessory cusps to play the role of the inclined plane and lead to deviations in the closure of the lower jaw. The fused teeth can cause aesthetic and occlusal disturbances in the anterior segment. Furthermore, double teeth can lead to ectopic eruption or noneruption of adjacent teeth due to their increased crown size as is the case with one of the presented patients. This is because a double tooth occupies more space in the dental arch. If not diagnosed early, impaction of the adjacent tooth, violation of the occlusal ratios (Bolton/anterior), and exacerbation of the orthodontic deformity can be observed. The modern CBCT imaging is the best diagnostic method for identifying problems related to tooth positions or tooth germs.

One of the important parameters in orthodontics is the perimeter of the dental arch. Precise assessment is necessary in cases of maxillary constriction treated with a rapid maxillary expander (RME). The orthodontic software allows customization of the processes from diagnosis to manufacturing of the treatment device. The aim of the present study is to evaluate a relationship between the parameters of the dental arch—perimeter, width, and length—and to follow the changes during treatment. The study is based on the digital measurements of 3D models of 33 patients treated with a digitally planned and printed RME. In the results an increase of 3.99 mm in perimeter was achieved. The rest of the parameters were changed as follows: The width of the dental arch was increased in the premolar area by an average of 3.3 mm; in the area of the first molars, the increase was 4.41 mm; the length of the dental arch in the anterior segment was reduced by an average of 0.54 mm; and the whole length by 0.52 mm. Correlation between the studied variables was described by linear equations. In conclusion, rapid maxillary expansion is a reliable method for gaining predictable space in the dental arch.