Mixed unilateral transposition of a maxillary canine, central incisor, and lateral incisor

A girl, aged 7 years 11 months, came for treatment with the chief complaint of lack of eruption of her maxillary right central and lateral permanent incisors. The radiographic analysis indicated complete transposition of the maxillary right lateral incisor and canine, and a pseudotransposition of the maxillary right central and lateral incisors. This is a clinical condition of mixed transposition in the same hemi-arcade: the combination of a complete transposition and another incomplete or coronary transposition—a situation that has not been reported in the literature. The patient was treated with surgical exposure and ligation of the 3 teeth, the eruption was properly guided, and the correct order of the 3 teeth was restored in the arch. The diagnosis, appliance design, and treatment sequence are described.