A retrospective study of the prevalence and characteristics of root dilaceration in a sample of the Turkish population

Root Dilaceration: A Case Report and Literature Review

The clinical management of impacted incisors affected by root dilaceration is challenging. This case report presents the treatment of an adolescent female patient who presented with a deeply impacted, rotated and dilacerated maxillary central incisor and also reviews the current literature on the definition, prevalence, aetiology, diagnosis, and treatment of the anomaly. The impacted and dilacerated incisor was successfully orthodontically treated following a two-stage surgical exposure and after being rotated 100 degrees in the sagittal plane (due to the deep impaction and severe displacement). A Ballista spring and piggyback appliance technique were used to elevate the tooth. The dilacerated incisor was successfully preserved and relocated in the dental arch. The pre-operative and post-operative CBCT scans showed no significant root resorption of the repositioned tooth.

Present status and future directions -Management of curved and calcified root canals

Root canal curvature and calcification introduce factors that increase the risk of procedural accidents during root canal treatment. The inability to achieve patency to the apical third, asymmetrical dentine removal leading to transportation, perforation and instrument fracture inside the curved trajectories are some of the procedural problems that might jeopardize the management of intraradicular infection and result in poor treatment outcomes. In fact, curved and constricted canals introduce such complexity that total instrumentation concepts and specially designed instruments have been developed to deal with the challenge. This narrative review seeks to provide and consolidate the principles necessary for understanding the dynamics of curved and constricted canal management and to improve the understanding for future developments in this field.

Root dilaceration in maxillary impacted canines and adjacent teeth: A retrospective analysis of the difference between buccal and palatal impaction

INTRODUCTION

This research aimed to analyze the prevalence of root dilaceration in buccally impacted canines (BICs) and palatally impacted canines (PICs) with their adjacent teeth based on a retrospective cone-beam computed tomography (CBCT) investigation.

METHODS

Pretreatment CBCT images of 145 subjects with unilateral maxillary canine impaction and 145 age- and sex-matched subjects without impaction were used. Prevalence of dilaceration (subclassified to root curvature and apical hook based on severity) in canines and adjacent teeth was determined in CBCT records. The root length of maxillary impacted canines was measured for further morphologic evaluations.

RESULTS

Impacted canines had a significantly higher prevalence of root dilaceration than the control group and compared with the erupted contralateral canines in the experimental group (P < 0.001 for both). A significantly higher prevalence of root dilaceration was found in adjacent lateral incisors of the PICs subgroup than that of the control group (P < 0.001). Adjacent premolars had a higher prevalence of dilacerated roots in the PICs subgroup (P < 0.001) than the control group, but not for the BICs subgroup. Significantly higher prevalence of curvature (P < 0.001 for both) and hook (P = 0.008 and P < 0.001, respectively) were found in BICs and PICs roots compared with the control group. Both types of impacted canines had significantly shorter roots than the control group (P < 0.001 for both).

CONCLUSIONS

BICs and PICs have a higher tendency to present root dilaceration and shorter roots. Unlike BICs, adjacent teeth to PICs were more frequently observed to have root dilaceration.

Can forces be applied directly to the root for correction of a palatally displaced central incisor with a dilacerated root?

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.

Frequency of crown and root dilaceration of permanent incisors after dental trauma to their predecessor teeth

BACKGROUND/AIMS

Dental trauma to the predecessor teeth can cause crown and root dilacerations to the successor teeth, which can interfere with the normal development of permanent teeth. The aims of this study were to verify the types of trauma more frequent to the predecessor teeth that cause dilaceration to their successor teeth, to determine the frequency of crown and root dilacerations in permanent incisors, taking into account the child's age at the time of trauma, and to describe the types of treatment performed.

MATERIALS AND METHODS

Details of 815 anterior primary teeth with dental injury were obtained from 483 dental records of children aged 0-9 years at the time of trauma.

RESULTS

Of 815 traumatized primary teeth, 161 successor teeth were clinically and radiographically reviewed until complete eruption and had some type of sequel. Avulsion and intrusive luxation were the most frequent types of trauma to the predecessor teeth that caused dilaceration to their successor teeth. Enamel discoloration (30.4%), hypoplasia (23.6%), root (14.3%) and crown (9.9%) dilacerations were the most common sequelae observed in the successor teeth. Root and crown dilacerations were more frequent in children aged more than and up to 3 years, respectively. Tooth extraction and orthodontic treatment were the most common treatments.

CONCLUSIONS

Dentists must be aware of the relationship between the child's age at the time of trauma to the predecessor tooth and the type of sequel to the successor tooth in order to diagnose, monitor, and treat the sequel properly.