Unilateral impaction of a maxillary first molar treated in the transitional dentition.

The purpose of this report was to present the case of a nine-year-old patient with unilateral impaction of the permanent maxillary right first molar treated early using a simple and effective fixed appliance. The proposed intervention involved the construction of a fixed palatal arch with a soldered wire extending distally to the impacted permanent first molar. A button was bonded to the occlusal surface of the molar, which was to be used as a leverage point for engaging chain elastics to produce distal movement to disimpact and allow complete eruption of the molar. Following three months of treatment, the permanent molar was in a physiologic position. This report demonstrates that, when this problem is identified early, pediatric dentists have the opportunity to minimize the complexity of future orthodontic treatment and limit the extent of malocclusion in the permanent dentition.