Periodontal implications of surgical-orthodontic treatment of an impacted dilacerated maxillary incisor: A case report with a 2-year follow-up

The effect of the root dilaceration on the treatment duration and prognosis of unilateral impacted immature maxillary central incisors

INTRODUCTION

This study aimed to investigate the effect of root dilaceration on the closed-eruption technique treatment and prognosis on impacted immature maxillary central incisors.

METHODS

In this retrospective study, we compared the age at the beginning of the treatment, the treatment duration, root development, and alveolar bone mass after the closed-eruption technique between the impacted immature maxillary central incisors with dilacerated roots (group 1) and those with straight roots (group 2).

RESULTS

The mean age at the time of the surgery of group 1 was 0.9 years younger than that of group 2 (P = 0.008). The mean traction time was greater in group 1 (8.0 ± 1.8 months), with a difference of 1.4 months than in group 2 (6.6 ± 2.1 months) (P = 0.042). The measurements of lingual bone thickness at the alveolar crest (C) showed significant differences between the 2 groups (P = 0.025). No significant differences were found in other treatment duration or measurements of root development and alveolar bone mass between the 2 groups.

CONCLUSIONS

Patients with impacted immature incisors with dilacerated roots were younger at the beginning of the closed-eruption treatment and had a longer traction time than those with impacted immature incisors having straight roots. The root dilaceration had little or no effect on root development and alveolar bone mass after the closed-eruption treatment. The closed-eruption treatment of impacted immature incisors with root dilaceration is suggested to commence as early as possible.

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.

Interdisciplinary orthodontic-periodontal treatment of unerupted permanent maxillary incisors following traumatic injury to deciduous teeth. Case report with long-term follow-up (11 years)

Orthodontic and periodontal treatment of the permanent maxillary teeth, which were retained due to trauma on the deciduous dentition, showed a perfect alignment of the teeth associated with healthy and stable periodontal tissues during an 11-year follow-up.