Fenestration and traction of an impacted maxillary central incisor using a custom CAD/CAM orthodontic appliance

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This case report describes the fenestration and traction treatment of an impacted maxillary left central incisor in a 10-year and 1-month-old girl using a customized appliance incorporating Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technology. The treatment appliance was based on a Nance-holding arch and integrated with a CAD/CAM crown to enhance traction efficiency and esthetics. Consequently, the impacted tooth was successfully guided into the dental arch as planned, achieving functional occlusion and esthetic harmony. No root resorption of the adjacent teeth was observed, and the patient reported high levels of comfort and esthetic satisfaction throughout the treatment. This case highlights the effectiveness of CAD/CAM technology in managing impacted teeth and suggests that customized appliance designs may contribute to improved treatment efficiency and patient satisfaction.