A competent orthodontist must attempt to either increase arch length or decrease tooth mass in order to uncrowd the developing cuspids and thereby prevent or minimize their ectopic eruption so as to prevent or limit damage to the roots of the lateral incisors. The orthodontist could utilize a palatal expansion appliance to increase anterior arch length and thereby uncrowd and prevent, or minimize, the ectopic eruption of the permanent cuspids which could prevent or limit damage to the roots of the lateral incisors. He could also attempt to increase arch length by moving the maxillary posterior teeth distally and thereby gain arch length to uncrowd the developing cuspids.
Acceptable treatment of this condition by a competent orthodontist could also involve sacrificing several deciduous teeth to guide and hasten the differential eruption of succedaneous teeth adjacent to the developing permanent cuspids in an attempt to uncrowd and guide the eruption of the developing cuspids and thereby prevent or limit damage to the roots of the lateral incisors. This procedure would also hasten the eruption of the permanent upper first premolars which could then be sacrificed to further uncrowd the developing permanent cuspids which would prevent or minimize their ectopic eruption in an attempt to prevent or limit damage to the roots of the lateral incisors.
Orthodontic medical expert witness specialties include orthodontics and dentistry.