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

Abstract

The treatment of an 8-year-old girl with a dilacerated maxillary incisor began in the mixed dentition; a modified palatal arch attached to the molars served as anchorage for the forced eruption of the dilacerated tooth to prevent the intrusion of the adjacent teeth and reduce the risk of root resorption. Two surgical sessions were planned: the first to permit the closed eruption; the second was an apically positioned flap to add attached gingiva to the labial side of the erupting tooth. The result was an optimal periodontal outcome; moreover, the roots of the adjacent teeth did not show any sign of resorption at the end of the forced eruption. The tooth was vital at the end of the treatment, and the apex covered by alveolar mucosa. The root developed normally throughout the treatment, and the periodontium was healthy and esthetically acceptable at the 2-year follow-up. Further study is needed to assess the advantages of the combined surgical-orthodontic treatment.

Root Dilaceration: A Case Report and Literature Review

“…The root of 21 was selected as the control reference, with the preop root length of 19.60 mm and post-op root length of 19.39 mm (Figure 13). Treatment success of the current case related to root resorption was similar to other reported cases; 2,21,26,28,29 however, the previous studies only qualitatively evaluated the root status on post-operative panoramic radiographs, without quantitative measurements. To the best of current knowledge, this is the first case report that measured and compared the resorption of the dilacerated root using CBCT with the contralateral incisor as the control reference.…”

“…Treatment time for an impacted dilacerated tooth has varied significantly between 11 and 45 months. 2,[26][27][28][29] The treatment time for the current case was 43 months due to the deep impaction and severe displacement. The influencing factors of treatment time usually include the complexity of the case, the type of malocclusion, and the stage of dental development.…”

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

“…14,15 Orthodontic appliances and techniques designed for this purpose have been proposed specifically for repositioning the impacted teeth on the maxillary arch. [16][17][18][19][20][21][22][23] The surgical procedures performed to expose the impacted teeth should respect the soft tissue as much as possible. In case of submucosal palatal impaction where only soft tissue is involved, the keratinized gingiva must be preserved and an apically positioned flap (APF) should be raised.…”

“…The most appropriate orthodontic treatment should be able to simulate the physiological eruption pattern of the permanent teeth that occurs at the center of the alveolar ridge as some authors have already suggested 14,15 . Orthodontic appliances and techniques designed for this purpose have been proposed specifically for repositioning the impacted teeth on the maxillary arch 16‐23 …”