A Rare Case of Positional Anomaly in anterior region with Root Dilaceration and Supernumerary Teeth: A Clinical Challenge with Multidisciplinary Management Plan and literature review

Abstract

Dental transposition is a rare anomaly, most frequently involving the maxillary canine, and is usually unilateral. Though reports of different transposition patterns exist, transposition of the maxillary canine into the central incisor position is extremely scarce, particularly when associated with anomalies such as root dilaceration, supernumerary teeth, or peg-shaped laterals. Trauma, obstruction, or genetic factors may disturb the normal eruptive sequence, leading to these anomalies.

This case describes an adolescent presenting with the transposition of the permanent maxillary canine toward the central incisor site, a dilacerated maxillary central incisor, and a supernumerary tooth in the premolar region. Such a constellation of anomalies is exceptionally rare and demands interdisciplinary management. A phased orthodontic plan, combined with surgical guidance, was adopted to address esthetic and functional concerns while preserving periodontal health. The case emphasizes the importance of early diagnosis, radiographic evaluation, and carefully staged multidisciplinary management for successful outcomes.