Traction of impacted and stacked maxillary anterior teeth with precise biomechanics followed by torque control using gate spring

Impaction of multiple maxillary anterior teeth is a rare condition; when it occurs, it impacts the patient's chewing function and smile esthetics, and it has always been problematic for clinicians. This case report presents an 11-year-old girl with impaction of 3 adjacent maxillary anterior teeth, including labiopalatally oriented maxillary right central and lateral incisors and a mesially inclined maxillary right canine. These 3 impacted and stacked teeth were sequentially aligned after surgical exposure and orthodontic traction, and the surrounding dentigerous cyst healed simultaneously. Precise and delicate biomechanics will control root movement and prevent root collision. Gate spring, a novel torquing auxiliary, was used for highly efficient root torque movements of the previously impacted incisors. After 32-month treatment, the patient's occlusion and esthetics greatly improved.