Fig. 3 Fig. 4 Although we realized that maintaining the transposition on the left side and normalizing tooth position on the right side would result in an asymmetry, we felt that this plan was in the patient's best interest. We decided to proceed and attempt to camouflage the asymmetry as much as possible. Self-ligating brackets were bonded to the upper and lower arches using digital indirect bonding. A canine bracket with 00 torque was used for the transposed upper left lateral incisor. A bracket was not initially bonded to tooth #11 because of lack of space. Instead, we started with an open coil spring on a 16 NiTi wire to work on gaining the necessary space. We also did not bond a bracket to tooth #7 out of concern that doing so could force the root of the lateral into the crowns of #6 and #8, potentially damaging the lateral root. Progression After five months of alignment the impacted teeth were surgically exposed and bonded with gold chains using a " closed exposure " technique. Initial traction involved a 17x25 NiTi continuous archwire with a 14 NiTi piggyback wire fed through crimpable double-tubes that were crimped on to the continuous wire between #4 and #5 and between #10 and #12. The piggyback wire was threaded though Fig. 5 both gold chains and engaged in a lateral incisor bracket that was bonded to #11. After three months of traction in this manner, a bracket was bonded to #7 and a 14 NiTi continuous archwire was placed, threading through both gold chains and engaging the upper right lateral bracket between the two chains. Two months later, a progress Panorex was taken (Fig. 3), at which point we started applying mesially-directed traction to #8 by wire-lacing all the teeth in the upper left quadrant and tying elastic thread from the DECEMBER 2024 | 24 | ORTHOTOWN.COM gold chain to #9. We applied distally directed traction to #6 in a similar fashion by lacing #3 through #5 and tying elastic thread from the gold chain to #5. From the time of surgical exposure to the time of tooth emergence, it took a total of 12 months to erupt #6 and 20 months to erupt #8. Once erupted, brackets were bonded and alignment was completed (Figs. 4 and 5). Total treatment time was 41 months. Enameloplasty was performed on upper anterior teeth to improve esthetics. Activehttp://www.ORTHOTOWN.COM