Four maxillary incisors: a case report.

This case report describes the dentofacial morphology and treatment of a 9-year-old female who presented with four maxillary incisors, and a combination of rare oral and cervical vertebral anomalies. The patient had a Class II division I malocclusion which was complicated by the presence of supernumerary permanent teeth: two supplemental maxillary central incisors, and a supplemental mandibular central incisor. She also had abnormalities of the cervical vertebrae, which were symptom-free. In addition, a number of surgical procedures had been performed in early childhood to treat a benign oral teratoma, cleft tongue, and an isolated cleft of the secondary palate. The dental treatment involved the extraction of the two most centrally placed maxillary central incisors, and the alignment of the maxillary arch with fixed orthodontic appliances.