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This is the first article in a three-part series considering uncommon dental anomalies and treatment approaches. Dental transpositions are rare anomalies which may present to the general dental practitioner or orthodontist. The management of transpositions is dependent on several factors, including the sub-type, severity and the other salient features of the malocclusion. Transposition may either be accepted or orthodontically corrected and the adoption of either approach must be preceded by thorough assessment of the patient.
CPD/Clinical Relevance: The presentation and management of transposition is variable. The general dental practitioner must be aware of the clinical features of a developing transposition as certain treatment options are only possible before the transposition is fully established. In addition, the orthodontist must be mindful of the potential for iatrogenic harm if these dental anomalies are managed injudiciously.
Article
Uncommon occlusal problems or unusual treatment options present challenges by virtue of their rarity; they are orthodontic ‘conundrums’. In this series, transposition, finishing cases to Class III molar relationship, and the slightly unusual extraction pattern of a single lower incisor, will be covered, beginning with an update on dental transposition, its common forms and its orthodontic management illustrated through photographs from clinical cases. Transposition may be defined as the positional interchange of two adjacent teeth, or the development or eruption of a tooth into a position ordinarily occupied by a non-adjacent tooth.1 Transpositions can be complete or incomplete (also termed pseudo-transposition). In the former, both crown and root are transposed, whereas in the latter form, the crowns appear transposed with the roots being in their normal positions.1 Transposition is a form of ectopic eruption and by definition requires teeth to erupt into, or develop in, aberrant positions.2
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