The development of a pathological process may occasionally produce unexpected tooth movements, resulting in undesirable effects upon the occlusion. A 14-year-old Caucasian male patient is reported where a mandibular second permanent molar was extruded and tilted by a rapidly developing odontogenic keratocyst, which became evident 1 year after commencing orthodontic fixed appliance therapy. The rapidity of onset, the mode of presentation, and the effects upon the occlusion are discussed.
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