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Yang Q, Yang L, Li N, Sun K, Li L, Wang Y, Han X, Wang T. Effect of force direction and impaction angulation during dilaceration impacted central incisor traction: a finite element analysis. BMC Oral Health 2024; 24:823. [PMID: 39033134 PMCID: PMC11264753 DOI: 10.1186/s12903-024-04601-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND The effects of traction forces at different angles on impacted central incisors(ICI)with varying inverted angles (IA) may be different. The objective of this study was to analyze the biomechanical effects of different force directions (FD) on developmentally inverted ICI with multi-angle variations and to offer insights and guidance for the treatment of inverted ICI. METHODS Three-dimensional finite element method was employed to simulate clinical scenarios of inverted ICI traction. As such, 0.2 N of force (direction: antero-superior angles of 90°, 100°, 110°, 120°, and 130° relative to the long axis of the inverted ICI crown) was applied to the inverted ICI with inverse angles (IA) of 40°, 30°, 20°, 10° and 0°. Inverted ICI apical displacement and Von Mises stress on periodontal ligament (PDL) and alveolar bone were compared. RESULTS IA and FD showed minimal influence on the stress distribution in the PDL, as higher stresses were concentrated in the apical region. The higher stresses in the alveolar bone are focused on the cervical and apical regions of the tooth. In particular, IA exerts a more significant impact on stress distribution in the alveolar bone than FD. The influence of IA on the apical displacement of inverted ICI is larger than that of FD. CONCLUSIONS To promote the health of the root and periodontal tissues, it is recommended to use an angle of 100°-110° relative to the long axis of the ICI crown when dealing with a large IA (> 20°) developmentally inverted ICI. Conversely, an angle of 110°-120° can be used.
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Affiliation(s)
- Qian Yang
- Binzhou Medical University, No. 346 Guanhai Road, Yantai, Shandong, 264000, China
| | - Liu Yang
- Department of Prosthodontics, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 142 North Avenue, Yantai, Shandong, 264000, China
| | - Ning Li
- Department of Orthodontics, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 142 North Avenue, Yantai, Shandong, 264000, China
| | - Kai Sun
- Binzhou Medical University, No. 346 Guanhai Road, Yantai, Shandong, 264000, China
| | - Liang Li
- Department of Orthodontics, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 142 North Avenue, Yantai, Shandong, 264000, China
| | - Yulan Wang
- Department of Orthodontics, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 142 North Avenue, Yantai, Shandong, 264000, China
| | - Xiaohang Han
- Binzhou Medical University, No. 346 Guanhai Road, Yantai, Shandong, 264000, China
| | - Tiejun Wang
- Department of Orthodontics, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 142 North Avenue, Yantai, Shandong, 264000, China.
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Sen Yavuz B, Yilmaz A, Haznedaroglu E, Sezer B, Okutan AE, Sezgin BI, Ozcelik M, Sezgin GI, Ugurlu F, Mentes A. Retrospective evaluation of traction time for impacted dilacerated maxillary central incisors in mixed dentition. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101485. [PMID: 37116703 DOI: 10.1016/j.jormas.2023.101485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/09/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
PURPOSES This study aimed to contribute to understanding the factors affecting the time of traction treatment of impacted dilacerated maxillary central incisors. METHODS This retrospective study included children aged 8 - 11 years with a history of trauma, who applied to the pediatric dentistry clinics of Marmara University, School of Dentistry, between December 2013 and December 2019, and were treated for unilateral impacted dilacerated maxillary upper central incisors. Children's age, sex, digital panoramic radiographs, cone-beam computed tomography, and intraoral photographs were retrieved from electronic dental health records. The effects of children's age, sex, the direction of impacted teeth, distance of the teeth to the top of the alveolar crest, and root dilaceration level on traction time were analyzed by Mann-Whitney U test and Spearman's rank correlation coefficient test. RESULTS The inverse position of the incisors significantly increased the traction time (P = 0.012). However, the traction time did not differ according to the sex of the children (P = 0.707) or the level of root dilaceration (P = 0.429). No correlation was observed between the traction time and the age of children (P = 0.644) or the distance of the incisors from the top of the alveolar crest (P = 0.397). CONCLUSIONS In cases of the forced eruption of for the impacted dilacerated maxillary central incisors, the direction of the teeth should be evaluated when deciding on the treatment plan, as it may affect the treatment time.
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Affiliation(s)
- Betul Sen Yavuz
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
| | - Ahu Yilmaz
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - Eda Haznedaroglu
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
| | - Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Alev Eda Okutan
- Department of Pediatric Dentistry, School of Dentistry, Istanbul Atlas University, Istanbul, Turkey
| | - Batin Ilgit Sezgin
- Department of Pediatric Dentistry, School of Dentistry, Istanbul Kent University, Istanbul, Turkey
| | - Mert Ozcelik
- Department of Pediatric Dentistry, School of Dentistry, Istanbul Istinye University, Istanbul, Turkey
| | | | - Faysal Ugurlu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Marmara University, Istanbul, Turkey
| | - Ali Mentes
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
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Zhao L, Matsumoto Y, Iseki S, Ono T. Effects of short-term orthodontic force application on the root at different developmental stages in rat maxillary molars. Am J Orthod Dentofacial Orthop 2022; 163:531-539.e2. [PMID: 36564315 DOI: 10.1016/j.ajodo.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The suitable timing and duration of orthodontic force to be applied to teeth with developing roots are unclear. We investigated the effects of short-term orthodontic force application on the roots at different root developmental stages in rats to predict the optimal timing for orthodontic treatment of teeth with developing roots. METHODS Light orthodontic force was applied on the maxillary first molars of rats from postnatal day (PN) 21 or PN28 for 3 days. After that, the force was released, and the roots were evaluated on PN35 to determine the root length, apical morphology, and cell proliferation of the maxillary first mesial roots using microcomputed tomography and histologic evaluation. RESULTS When a light orthodontic force was applied from PN21, the root length did not differ from that in age-matched controls. In addition, after the force was released, the roots attained the normal root-completing length and had a well-formed root apical morphology at PN35. Conversely, when the force was applied from PN28, the roots showed apical abnormalities characterized by deformed dentin and disorganized arrangement of odontoblasts, reduced apical cell proliferation, and significantly shorter length than those in the age-matched controls at PN31. The shortened root and disturbed apical integrity could not be rescued by releasing the orthodontic force at PN35. CONCLUSIONS Short-term orthodontic force at the late and slow root developmental stage results in a shortened root and a defect in the root apex with reduced cell proliferation. Our findings support that orthodontic force for a limited duration during the active and rapid root developmental stage is more favorable than during the late and slow stage.
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Affiliation(s)
- Lu Zhao
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China; Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiro Matsumoto
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Sachiko Iseki
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Bai Y, Cui J, Sun H, Zhou Z, Shi L, Li P, Liu J. The enhanced conservation of vital pulp and apical tissues by the application of crown rotation surgery for inversely impacted central incisors: a follow-up analysis of two patients over four years. Int Endod J 2022; 55:882-888. [PMID: 35543607 DOI: 10.1111/iej.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022]
Abstract
AIM To describe a novel surgical method (crown rotation surgery) to manage inversely impacted central incisors with immature roots. SUMMARY Two young patients each presented with an inversely impacted maxillary central incisor. To protect the apical tissues, the two impacted incisors were rotated downwards to a relatively normal position without extraction from their bony sockets. After crown rotation surgery, spontaneous eruption, continuous root development, and periodontal healing of the rotated incisors were observed. The pulp retained vitality and blood flow was normal. Moreover, there were no obvious signs of pulp canal obliteration (PCO), as indicated by Cone Beam Computed Tomography (CBCT) imaging. KEY LEARNING POINTS • By optimising protection of the vital pulp and apical tissues, crown rotation surgery represents a minimally invasive, conservative, and practical surgical technique for treating inversely impacted incisors with developing roots. • In contrast to existing surgical methods, crown rotation surgery may avoid certain complications, including PCO and abnormal or arrested root development.
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Affiliation(s)
- Yudi Bai
- Department of Stomatology, Air Force Medical Center, Fourth Military Medical University (FMMU), Beijing, 100142, China
| | - Jiantong Cui
- First Clinical Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Hua Sun
- Lintong Sanatorium Center of PLA, Xi'an, 710600, China
| | - Zhifei Zhou
- Department of Stomatology, General Hospital of Tibetan Military Command, Lhasa, Tibet, 850000, China
| | - Liqiang Shi
- Department of Radiology, School of Stomatology, FMMU, Xi'an, 710032, China
| | - Pan Li
- Zibo Stomatological Hospital, Zibo City, Shandong Province 255000, China
| | - Jin Liu
- Department of Operative Dentistry and Endodontics, School of Stomatology, FMMU, Xi'an, 710032, China.,Huangshan City People's Hospital, Anhui Province, China
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The Morphology of Impacted Maxillary Central Incisors: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58040462. [PMID: 35454301 PMCID: PMC9026335 DOI: 10.3390/medicina58040462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: The knowledge of the morphology of impacted maxillary central incisors may lead to more effective treatment. Therefore, this systematic review aimed to evaluate the morphology of impacted maxillary central incisors and compare them with contralateral teeth. Material and methods: This systematic review adhered to the PRISMA statement. The literature search was carried out using PubMed (Medline database), Cochrane Library, ProQuest, Web of Science and Science Direct electronic databases with no publication date restrictions up to July 2021. Data assessing the morphology of unilaterally impacted maxillary central incisors (ICI) evaluated with CBCT were extracted, and the quality of the studies was evaluated. Crown length, root length, and root dilaceration of impacted maxillary central incisors were compared with contralateral unimpacted teeth. Results: The initial database search identified a total number of 287 studies. After applying the selection criteria, 21 articles were selected for a full-text analysis, and four retrospective studies involving 205 patients were included in the systematic review. According to the Newcastle-Ottawa Scale (NOS), two of included articles were graded as “Good” and the remaining two as “Fair” quality. The results showed no difference between impacted teeth and their contralateral crowns, or a minor decrease in ICI crown length (from 0.15 to 0.56 mm). The root lengths of impacted maxillary central incisors were considerably shorter than contralateral incisors (from 2.13 to 3.22 mm) and, as dental age increased, root growth decreased and the incidence of root dilaceration was more frequent. Conclusions: The root lengths of impacted maxillary central incisors were considerably shorter compared to the contralateral incisors. Root dilacerations frequency and severity increased as dental age increased.
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Impacted Central Incisors in the Upper Jaw in an Adolescent Patient: Orthodontic-Surgical Treatment—A Case Report. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052657] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The inclusion of both maxillary permanent central incisors is uncommon. This condition compromises face aesthetics, phonation and masticatory function. Therefore, early diagnosis is essential to avoid complications and failures. There are various reasons for inclusion, but supernumerary teeth are the leading cause. Early causes of removal and rapid expansion of the palate determine a high probability of success with the spontaneous eruption of the impacted elements. However, it is often necessary to proceed with a surgical–orthodontic treatment. The inclination of teeth in relation to the midline and the root maturation degree determine prognosis and therapeutic timing. In this case report, the orthopantomogram (OPG) X-ray of a 9-year-old boy revealed two impacted supernumerary teeth in the anterior maxillary region, preventing the eruption of the permanent upper central incisors. The impacted supernumerary teeth were surgically removed at different times. A straight wire multibrackets technique associated with a fixed palatal appliance was used. The palatal appliance featured an osteomucous resin support at the level of the retroincisal papilla. Subsequently, surgical exposure was carried out using the closed eruption technique and elastic traction, bringing 11 and 21 back into the arch.
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In situ rotation surgery for correction of growing, inversely impacted maxillary central incisors. Am J Orthod Dentofacial Orthop 2021; 159:536-544. [PMID: 33568277 DOI: 10.1016/j.ajodo.2020.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022]
Abstract
Treatment of an impacted incisor with a dilacerated root is challenging for clinicians because of the position of the impacted incisor, the abnormality of the root, unfavorable prognosis, and, especially, the long treatment duration. We report on 2 young patients who had inversely impacted maxillary central incisors with developing labially dilacerated roots. Both patients were treated by a novel surgical approach, in situ rotation, by which the crowns of the inversely impacted incisors were carefully rotated to a relatively normal position, whereas the apical location remained relatively unchanged. About 2 weeks after surgery, spontaneous eruption of the treated incisors was observed. Three months later, the postoperative central incisors were further aligned into the maxillary arch with a fixed orthodontic appliance. Follow-up visits 2 or 3 years after surgery indicated that the positions of the dilacerated incisors maintained stability with good gingival esthetics, and the pulpal vitality was favorable. The roots grew further in a relatively normal direction of the incisor's longitudinal axis, which was different from the initial curvature angle. Moreover, with the in situ rotation surgery, treatment time was greatly reduced and resulted in a favorable prognosis compared with conventional treatment.
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8
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Arango E, Plaza SP, Chaves AM, Melsen B. Can forces be applied directly to the root for correction of a palatally displaced central incisor with a dilacerated root? Am J Orthod Dentofacial Orthop 2019; 156:275-282. [PMID: 31375238 DOI: 10.1016/j.ajodo.2018.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 12/22/2022]
Abstract
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.
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Affiliation(s)
- Elsa Arango
- Fundación Universitaria UniCIEO, Bogotá, Colombia.
| | | | | | - Birte Melsen
- Department of Orthodontics, Klinik für Kieferorthopedie Medizinische Hochshule, Hannover, Germany; Department of Orthodontics, University of Western Australia, Perth, Western Australia, Australia; Department of Orthodontics, Kentucky University, Lexington, Ky
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Bhikoo C, Ye H, Chen T, Zhang L, Wu G, Leung Wing Chung AKJ, Volière G, Hu R. Association between palatally displaced maxillary central incisors and lateral incisors: A retrospective cone-beam computed tomographic study. Am J Orthod Dentofacial Orthop 2019; 156:44-52. [PMID: 31256835 DOI: 10.1016/j.ajodo.2018.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The objective of this study was to investigate the location, orientation and root development of maxillary lateral incisors in patients with palatally impacted central incisors. Comparison was made between the lateral incisor on the affected side and that on the normally erupted side. METHODS Cone-beam computed tomographic images from 20 patients (10 boys, 10 girls, mean age (9.01 ± 1.52 years old) with unilateral palatally impacted maxillary central incisors were imported into Dolphin imaging software 11.8 for 3-dimensional reconstruction and reorientation. Software measurement tools were used to measure the root length, crown distance, angle to palatal plane, distance to midline, and angle to midsagittal plane of the maxillary lateral incisors on both the impacted and unaffected sides. RESULTS The Wilcoxon signed rank test indicated that lateral incisors on the impacted side were more proclined, at a mean angle difference of 29.47° in the sagittal plane (P < 0.001). The mean length of the roots of the lateral incisors was 1.21 mm shorter (P < 0.05) on the affected side compared with the normal side, and the lateral incisor crowns on the impacted side were located at an average of 4.57 mm closer to the palatal plane than on the normally erupted side (P < 0.001). The angle of long axis of the lateral incisors on the affected side had a greater angulation to the midsagittal plane compared with the unaffected side, with a mean difference of 30.27° (P < 0.001). CONCLUSIONS Maxillary lateral incisors adjacent to palatally impacted maxillary central incisors side had abnormal root development and demonstrated angulation and position change compared with those adjacent to normally erupted central incisors.
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Affiliation(s)
- Chandradev Bhikoo
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Huihuang Ye
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Tingting Chen
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Leqi Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Guosheng Wu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Ah Kong Junior Leung Wing Chung
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Gerald Volière
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Rongdang Hu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
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Singh H, Kapoor P, Sharma P, Dudeja P, Maurya RK, Thakkar S. Interdisciplinary management of an impacted dilacerated maxillary central incisor. Dental Press J Orthod 2018; 23:37-46. [PMID: 30088564 PMCID: PMC6072448 DOI: 10.1590/2177-6709.23.3.037-046.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/02/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Tooth dilacerations are dental anomalies characterized by an abrupt deviation in the longitudinal axis of a tooth. They may occur either in the crown, between the crown and root, or in the root. Although not so common, impacted maxillary incisors exhibiting root dilaceration pose a diagnostic and treatment challenge to the clinician. DESCRIPTION This case report describes the management of a horizontally impacted and dilacerated maxillary central incisor in a 12-year-old girl. Cone-beam computed tomographic scans were used to accurately localize the position of the dilacerated tooth, and to assess the extent of root formation and degree of dilaceration present in the root. Treatment included surgical exposure and orthodontic traction, followed by root canal treatment and apicoectomy. RESULTS Through a meticulously planned interdisciplinary approach, the impacted dilacerated central incisor was properly aligned and demonstrated good stability after the long-term follow-up. CONCLUSION Taking into consideration the concerns and expectations of the patient, communicative feedback between the oral surgeon, orthodontist and endodontist helped achieving successful esthetic, structural and functional outcome in the present case.
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Affiliation(s)
- Harpreet Singh
- ESIC Dental College and Hospital, Department of Orthodontics and Craniofacial Orthopedics (New Delhi, India)
| | - Pranav Kapoor
- ESIC Dental College and Hospital, Department of Orthodontics and Craniofacial Orthopedics (New Delhi, India)
| | - Poonam Sharma
- ESIC Dental College and Hospital, Department of Orthodontics and Craniofacial Orthopedics (New Delhi, India)
| | - Pooja Dudeja
- ESIC Dental College and Hospital, Department of Conservative Dentistry and Endodontics (New Delhi, India)
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Bhikoo C, Xu J, Sun H, Jin C, Jiang H, Hu R. Factors affecting treatment duration of labial inversely impacted maxillary central incisors. Am J Orthod Dentofacial Orthop 2018; 153:708-715. [DOI: 10.1016/j.ajodo.2017.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 01/10/2023]
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12
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Chang NY, Park JH, Kim SC, Kang KH, Cho JH, Cho JW, Jang HE, Chae JM. Forced eruption of impacted maxillary central incisors with severely dilacerated roots. Am J Orthod Dentofacial Orthop 2016; 150:692-702. [DOI: 10.1016/j.ajodo.2016.04.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/17/2022]
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13
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Sun H, Hu R, Ren M, Lin Y, Wang X, Sun C, Wang Y. The treatment timing of labial inversely impacted maxillary central incisors: A prospective study. Angle Orthod 2016; 86:768-774. [PMID: 26938954 PMCID: PMC8600833 DOI: 10.2319/083015-584.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 01/01/2016] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE To determine the timing of treatment for the labial inversely impacted maxillary central incisors. METHODS Twenty-eight patients (mean age, 8.2 years) with labial inversely impacted maxillary central incisors were divided into early-treated and later-treated groups according to their dental age. All of the patients were treated with a combination of surgery and orthodontic traction using the Guide rod appliance. Cone-beam computed tomography images were taken immediately after treatment for assessing the root morphology, root length, and alveolar bone loss. Sagittal slices were evaluated at the widest labial-lingual width of the tooth in the axial view. All variables were evaluated by Simplant 13.0 software (Materialise Dental NV, Leuven, Belgium). RESULTS The rank sum test indicated that the root length of two groups showed a statistically significant difference between the impacted and homonym tooth, with a shorter length in the impacted tooth (P < .05). The D-value (difference of root length between the impacted and homonym tooth) and alveolar bone loss on the labial side of the impacted incisor are significantly less in the early-treated groups when compared with the later-treated groups (P < .05). Spearman rank correlation analysis showed a statistically positive association between the treatment timing and D-value (r = .623, P < .05). The chi-square test for morphology of root apex indicated that the incidence of the root-apex-directed labial side is significantly higher in the later-treated groups when compared with the early-treated groups. CONCLUSION The labial inversely impacted maxillary central incisors should be treated early to promote root development by achieving a better morphology of root apex, thus reducing the risk of alveolar bone loss on the labial side.
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Affiliation(s)
- Hao Sun
- Resident Doctor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rongdang Hu
- Professor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Manman Ren
- Postgraduate Student, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan Lin
- Attending Physician, Department of Stomatology, People’s Hospital of Lishui, Lishui, Zhejiang, China
| | - Xiuying Wang
- Resident Doctor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaofan Sun
- Resident Doctor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yi Wang
- Resident Doctor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Walia PS, Rohilla AK, Choudhary S, Kaur R. Review of Dilaceration of Maxillary Central Incisor: A Mutidisciplinary Challenge. Int J Clin Pediatr Dent 2016; 9:90-8. [PMID: 27274164 PMCID: PMC4890071 DOI: 10.5005/jp-journals-10005-1341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 10/10/2015] [Indexed: 11/23/2022] Open
Abstract
Traumatic injuries to primary dentition may interfere with the development of permanent dentition. Among the many malformations, dilaceration is particularly important to the clinician. Management of dilacerated maxillary central incisor requires a multidisciplinary approach. The main purpose of this review is to present the etiological factors, the mechanism, clinical features, radiographic features and treatment of dilaceration of the maxillary central incisors. How to cite this article: Walia PS, Rohilla AK, Choudhary S, Kaur R. Review of Dilaceration of Maxillary Central Incisor: A Multidisciplinary Challenge. Int J Clin Pediatr Dent 2016;9(1):90-98.
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Affiliation(s)
- Pawanjit Singh Walia
- Professor and Head, Department of Orthodontics, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
| | - Ajit Kumar Rohilla
- Reader, Department of Orthodontics, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
| | - Shweta Choudhary
- Reader, Department of Prosthodontics, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
| | - Ravneet Kaur
- Senior Lecturer, Department of Orthodontics, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
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15
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Spoerri A, Signorelli C, van Waes H. Surgical repositioning of a developing maxillary central incisor. A case report. Int J Paediatr Dent 2015; 25:305-8. [PMID: 25131644 DOI: 10.1111/ipd.12129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND A traumatic injury to the primary dentition can cause damage to the germ of the permanent successor. As a clinical consequence a dilaceration with root deformation, malpositioning and disturbances of eruption can occur. Surgical repositioning of such a dislocated crown of a developing tooth can be a treatment option. CASE REPORT A four year old patient was referred to our clinic because of a mobile upper primary central incisor and a radiographically visible displaced dental crown. Her history revealed a traumatic dental injury one year ago. Radiologic examination confirmed an inflammatory root resorption on tooth 61 and a dislocation of the developing tooth 21. In order to avoid further displacement due to the inflammation, 61 was extracted at the first appointment. A radiographic image 7 months later showed no improvement in the malposition of tooth 21. Therefore tooth 21 was surgically repositioned into its correct position. Follow-up over 3 years confirmed a continued root development and a full eruption of 21 in its correct position. CONCLUSION Early diagnosis and early treatment of a dislocated permanent tooth germ is essential to allow a favorable outcome. Surgical repositioning can be successful in avoiding later malpositioning of the permanent teeth.
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Affiliation(s)
- Andreas Spoerri
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Caroline Signorelli
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Hubertus van Waes
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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16
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Bhatia SK, Goyal A, Gauba K, Acharya S. Unusual root development following surgical repositioning of horizontally developing central incisor. Dent Traumatol 2015; 31:413-7. [PMID: 26040300 DOI: 10.1111/edt.12182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 12/17/2022]
Abstract
Dilaceration is one of the causes of maxillary central incisor eruption failure. If the dilacerated maxillary permanent central incisor is in a horizontal or vertical position and root formation is in early stages, surgical repositioning is frequently the treatment of choice. In this article, the case of a horizontally impacted and dilacerated maxillary central incisor is presented which was treated by surgical repositioning. The tooth developed an unusual form of the root with discontinuity at the middle third region with the coronal and apical parts growing separately. Radiographic and clinical monitoring of the case was regularly performed. The tooth completely erupted in 2 years after the repositioning and even after 6 years of surgery is currently successfully functional in the arch with the malformed root. This article highlights the ability of Hertwig's epithelial root sheath to withstand trauma and its ability to recover.
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Affiliation(s)
- Sarabjot Kaur Bhatia
- Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashima Goyal
- Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Gauba
- Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivesh Acharya
- Department of Pediatric and Preventive Dentistry, Bhojia Dental College & Hospital, Baddi, Himachal Pradesh, India
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17
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Impacted central incisors: Factors affecting prognosis and treatment duration. Am J Orthod Dentofacial Orthop 2015; 147:355-62. [DOI: 10.1016/j.ajodo.2014.11.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/01/2014] [Accepted: 11/01/2014] [Indexed: 11/21/2022]
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18
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Sun H, Wang Y, Sun C, Ye Q, Dai W, Wang X, Xu Q, Pan S, Hu R. Root morphology and development of labial inversely impacted maxillary central incisors in the mixed dentition: A retrospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2014; 146:709-16. [DOI: 10.1016/j.ajodo.2014.07.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 11/29/2022]
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19
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Rizzatto SMD, de Menezes LM, Allgayer S, Batista EL, Freitas MPM, Loro RCD. Orthodontically induced eruption of a horizontally impacted maxillary central incisor. Am J Orthod Dentofacial Orthop 2013; 144:119-29. [DOI: 10.1016/j.ajodo.2012.08.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 08/01/2012] [Accepted: 08/01/2012] [Indexed: 10/26/2022]
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20
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Continued root development of a surgically repositioned human incisor tooth germ. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e11-5. [DOI: 10.1016/j.oooo.2011.10.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 10/06/2011] [Accepted: 10/18/2011] [Indexed: 11/19/2022]
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21
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Wei YJ, Lin YC, Kaung SS, Yang SF, Lee SY, Lai YL. Esthetic periodontal surgery for impacted dilacerated maxillary central incisors. Am J Orthod Dentofacial Orthop 2012; 142:546-51. [PMID: 22999678 DOI: 10.1016/j.ajodo.2011.07.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 07/01/2011] [Accepted: 07/01/2011] [Indexed: 10/27/2022]
Abstract
Clinicians do not frequently see impacted dilacerated maxillary incisors in their patients. When they do, there are several diagnostic and management challenges for correcting root dilacerations. An unfavorable esthetic outcome might occur as a result of soft-tissue complications during surgical eruption procedures. We present 2 patients with an impacted and dilacerated maxillary central incisor. Computed tomography scans with 3-dimensional reformation were used to accurately assess the positions of the dilacerated teeth, the degree of dilaceration, and the stage of root formation. The therapy primarily involved 2-stage crown exposure surgery combined with orthodontic traction. An apicoectomy was performed on 1 dilacerated tooth; the other exhibited pulp vitality. This article highlights the periodontal surgical strategies for the esthetic management of inverted crowns. Through periodontal plastic surgery and interdisciplinary cooperation, the impacted dilacerated central incisors were properly aligned, and successful esthetic results were achieved.
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Affiliation(s)
- Yu-Ju Wei
- Division of Periodontology, Department of Stomatology, Taipei Veterans General Hospital, Taiwan.
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22
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Pinho T. Impaction of both maxillary central incisors and a canine. Am J Orthod Dentofacial Orthop 2012; 142:374-83. [PMID: 22920704 DOI: 10.1016/j.ajodo.2010.10.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 10/01/2010] [Accepted: 10/01/2010] [Indexed: 11/19/2022]
Abstract
This case report describes the treatment of a 14-year-old adolescent patient who had 2 impacted maxillary central incisors with distoangular root dilacerations. He also had an impacted maxillary left canine, with the crown completely overlapping the root of the lateral incisor, and insufficient space. The general dentist referred this patient because the maxillary central incisors had still not erupted 2 years after extraction of the retained deciduous incisors. A unilateral expander with a modified vestibular arch and an attachment spring on the right side was used to correct the posterior crossbite on the right side and improve the positions of the teeth. The expansion appliance was also applied as a high anchorage device to move the central incisors and the left canine into position during the initial stages. After this phase, fixed appliances were used to redistribute the space in the anterior maxillary region to create enough space for repositioning the impacted teeth. This procedure restored the normal appearance of the maxillary arch, with good periodontal health and without evidence of root resorption, apart from the distoangular root dilacerations of the 2 maxillary central incisors.
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Affiliation(s)
- Teresa Pinho
- Department of Orthodontics, Centro de Investigação Ciências da Saúde, Instituto Superior de Ciências da Saúde-Norte/CESPU, Gandra, Portugal.
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Pavlidis D, Daratsianos N, Jäger A. Treatment of an impacted dilacerated maxillary central incisor. Am J Orthod Dentofacial Orthop 2011; 139:378-87. [DOI: 10.1016/j.ajodo.2009.10.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 10/01/2009] [Accepted: 10/01/2009] [Indexed: 11/26/2022]
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24
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Muthumani T, Rajasekaran M, Veerabahu M, Indra R. Interdisciplinary management of impacted maxillary central incisor with dilacerated crown. J Endod 2011; 37:269-71. [PMID: 21238816 DOI: 10.1016/j.joen.2010.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 11/11/2010] [Accepted: 11/12/2010] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Dilaceration of the permanent teeth usually occurs because of trauma to their deciduous predecessors. Dilaceration in the crown is rare compared with that in the root and is more common in the maxillary and mandibular incisors. Generally, surgical exposure of the tooth followed by orthodontic traction or extraction of the tooth is the the choice of treatment. METHODS This article highlights a surgical-endodontic approach to the management of the left permanent maxillary central incisor with dilaceration of the crown. RESULTS The 1-year follow-up showed good stability of the prosthesis and good periodontal health. CONCLUSIONS Surgical resection of the crown followed by endodontic treatment and restoration is a viable and rapid option for the management of crown dilaceration.
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Affiliation(s)
- Thangamani Muthumani
- Department of Oral and Maxillofacial Surgery, Ragas Dental College and Hospital, Chennai, India.
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25
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Adlakha VK, Chandna P, Gandhi S, Chopra S, Singh N, Singh S. Surgical Repositioning of a Dilacerated Impacted Incisor. Int J Clin Pediatr Dent 2011; 4:55-8. [PMID: 27616860 PMCID: PMC4999639 DOI: 10.5005/jp-journals-10005-1082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 09/29/2010] [Indexed: 11/23/2022] Open
Abstract
Dilaceration is one of the most common complications of trauma to deciduous dentition. The possible causes of dilaceration are trauma and developmental disturbances, while some authors suggest an association with some developmental syndromes. Dilaceration can be seen in both the permanent and deciduous dentition. The present case report describes surgical repositioning of a dilacerated impacted maxillary central incisor in a 9-year-old boy.
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Affiliation(s)
- Vivek Kumar Adlakha
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Preetika Chandna
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Sumir Gandhi
- Reader, Department of Oral Surgery, Christian Dental College, Ludhiana, Punjab, India
| | - Saroj Chopra
- Professor, Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - Namita Singh
- Professor, Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - Shamsher Singh
- Lecturer, Department of Pedodontics and Preventive Dentistry, Surindra Dental College, Ganganagar, Rajasthan, India
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Topouzelis N, Tsaousoglou P, Pisoka V, Zouloumis L. Dilaceration of maxillary central incisor: a literature review. Dent Traumatol 2010; 26:427-33. [PMID: 20831640 DOI: 10.1111/j.1600-9657.2010.00915.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The main purpose of this review is to present the aetiological factors and the mechanism that cause dilaceration of the maxillary central incisors. In early developmental stages, the permanent tooth germ of the maxillary incisor is situated palatally and superiorly to the apex of the primary incisor and gradually changes direction in a labial direction with its crown coming closer to the resorbing primary root. For reasons of this close relationship between the permanent tooth germ and the apex of the primary incisor, it is believed that an acute trauma to the primary predecessor can cause dilaceration of the long axis of the permanent successor. Clinically, dilaceration can be revealed by palpation high in the labial sulcus or in the hard palate, while its radiographic view is characteristic. The therapeutic approach to the dilacerated maxillary central incisors has to be carefully planned and needs the cooperation of several specialities to attain the final objective.
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Affiliation(s)
- Nikolaos Topouzelis
- Department of Orthodontics, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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27
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Topouzelis N, Tsaousoglou P, Gofa A. Management of root dilaceration of an impacted maxillary central incisor following orthodontic treatment: an unusual therapeutic outcome. Dent Traumatol 2010; 26:521-6. [DOI: 10.1111/j.1600-9657.2010.00937.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Farronato G, Maspero C, Farronato D. Orthodontic movement of a dilacerated maxillary incisor in mixed dentition treatment. Dent Traumatol 2009; 25:451-6. [DOI: 10.1111/j.1600-9657.2008.00722.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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29
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de Oliveira Ruellas AC, de Oliveira AM, Pithon MM. Transposition of a canine to the extraction site of a dilacerated maxillary central incisor. Am J Orthod Dentofacial Orthop 2009; 135:S133-9. [PMID: 19362264 DOI: 10.1016/j.ajodo.2007.10.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 08/22/2007] [Accepted: 10/23/2007] [Indexed: 10/20/2022]
Abstract
This article describes the treatment of a girl in whom anterior trauma during the deciduous dentition had caused a dilacerated maxillary central incisor in the mixed dentition. The dilacerated central incisor was extracted, and a canine was transposed to the extraction site. Canine transposition was performed so that the lateral incisor could be maintained in its normal position. This article discusses the clinical implications of dental dilacerations on orthodontic treatment and the treatment possibilities.
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30
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Maia RL, Vieira APGF. Auto-transplantation of central incisor with root dilaceration. Technical note. Int J Oral Maxillofac Surg 2004; 34:89-91. [PMID: 15617974 DOI: 10.1016/j.ijom.2004.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2004] [Indexed: 11/29/2022]
Abstract
A case of central incisor with root dilaceration and ensuing impactation was treated by means of auto-transplantation. The 7-year follow-up period shows a stable result.
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Affiliation(s)
- R L Maia
- Universidade Federal do Ceara, Fortaleza-CE, Brazil
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