{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:55:09Z","timestamp":1782888909785,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Tooth impaction and transposition are developmental dental anomalies that pose significant challenges in orthodontics, oral surgery, and restorative dentistry. These anomalies disrupt normal occlusal development and complicate diagnosis and treatment planning because of altered anatomy, a higher risk of adjacent tooth resorption, associated pathology such as cyst formation, and biomechanical challenges during orthodontic intervention. Methods: Three paediatric patients with complex eruption disturbances, including impacted incisors, impacted primary molars, and transposed maxillary canines, were managed using individualised conservative orthodontic approaches. The cases involved obstruction by supernumerary teeth, ectopic eruption with space loss, and tooth transposition complicated by root dilaceration and malocclusion. Comprehensive clinical and radiographic assessment, including CBCT when indicated, guided treatment planning. Management strategies included staged surgical interventions, space maintenance using 2 \u00d7 4 appliances, bite opening, and controlled orthodontic traction with modified biomechanics to minimise the risk of root resorption and interference with adjacent teeth. Results: Favourable functional and aaesthetic outcomes were achieved in all cases, although certain limitations such as incomplete root development, residual spacing, localised restorative complications, and difficulty in correcting root angulation of dilacerated adjacent teeth were observed. Conclusions: Careful diagnosis using advanced imaging, combined with conservative orthodontic and surgical approaches, can achieve satisfactory functional and esthetic outcomes while minimising complications. Further longitudinal studies are recommended to evaluate long-term stability and optimise treatment protocols.<\/jats:p>","DOI":"10.3390\/children13070879","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:06:34Z","timestamp":1782875194000},"page":"879","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Challenges in the Management of Complex Tooth Impaction and Transposition: A Case Series"],"prefix":"10.3390","volume":"13","author":[{"given":"Hana Omar","family":"AlBalbeesi","sequence":"first","affiliation":[{"name":"Department of Pediatric Dentistry and Orthodontics, Dental University Hospital, King Saud University, Riyadh 11545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2887-5330","authenticated-orcid":false,"given":"Eman Ibrahim","family":"Alshayea","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.59987\/ads\/2025.4.456-461","article-title":"Tooth impaction and inclusion: Challenges and advances in diagnosis and treatment","volume":"16","author":"Lione","year":"2025","journal-title":"Ann. Di Stomatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pinto, A.C., Francisco, H., Marques, D., Martins, J.N.R., and Caram\u00eas, J. (2024). Worldwide prevalence and demographic predictors of impacted third molars: A systematic review with meta-analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247533"},{"key":"ref_3","first-page":"e327","article-title":"Incidence, severity and orthodontic treatment difficulty index of impacted canines in Saudi population","volume":"10","author":"Alhammadi","year":"2018","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.sdentj.2019.10.002","article-title":"Prevalence and pattern of impacted canines in Najran, South Western Saudi Arabian population","volume":"32","author":"Alyami","year":"2020","journal-title":"Saudi Dent. 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