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References

MacPhee CG The incidence of erupted supernumary teeth in consecutive series of 4000 school children. Br Dent J. 1935; 58:59-60
DiBiase DD Midline supernumaries and eruption of maxillary central incisors. Trans BSSO. 1968–1969; 83–88
Brin I, Zilberman Y, Azaz B The unerupted maxillary central incisor: review of its aetiology and treatment. ASDC J Dent Child. 1982; 49:352-356
Andreasen JO Etiology and pathogenesis of traumatic dental injuries. A clinical study of 1,298 cases. Scand J Dent Res. 1970; 78:(4)329-342
Yeung K, Cheung R, Tsang M Compound odontoma associated with an unerupted and dilacerated maxillary primary central incisor in a young patient. Int J Paediatric Dent. 2003; 13:208-212
Andreasen JO, Ravn JJ The effect of traumatic injuries to primary teeth on their permanent successors. II. A clinical and radiographic follow-up study of 213 teeth. Scand J Dent Res. 1971; 79:(4)284-294
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Becker ALondon: Martin Dunitz Ltd; 1998

Multidisciplinary management of an impacted maxillary central incisor with a severe crown dilaceration

From Volume 8, Issue 3, July 2015 | Pages 86-90

Authors

Lisa Walshe

BA, BDentSc(TCD), MFDS(RCSI)

Oral and Maxillofacial Registrar, St James's Hospital, James's Street, Dublin 8

Articles by Lisa Walshe

Ciara Scott

BDS(UBrist), MFD(RCSI), MOrth(RCSEd), MDentCh(UDub) FFD (RCSI)

Specialist in Orthodontics, Regional Orthodontic Unit, St Columcilles Hospital, Dublin 18, Eire

Articles by Ciara Scott

Abstract

An 8-year-old girl presented with an unerupted upper right central incisor. Clinical and radiographic examination revealed a severe crown dilaceration. Her treatment involved a multidisciplinary approach, including surgical exposure, orthodontics and restorative treatment. The outcome was the accomplishment of a vital, functional and aesthetic maxillary central incisor with a good prognosis.

Clinical Relevance: This case report describes how a dilacerated upper incisor, which has failed to erupt and appears to be of poor prognosis, can be aligned with a satisfactory aesthetic and functional outcome. Alignment of the affected tooth improves dental appearance in the medium term and maintains alveolar bone if restorative replacement is required in the longer term.

Article

An upper central incisor will usually erupt between 7 and 8 years old. Dental age and chronological age do not always correlate, but a central incisor should erupt within 6 months of the contralateral tooth and within 12 months after the lower incisors. The incidence of unerupted maxillary central incisor teeth in the 5–12 year-old group has been reported as 0.13%.1 In a referred population to regional hospitals the prevalence has been estimated as 2.6%.2 Maxillary incisors are the third most commonly impacted teeth in Caucasians, following the third molars and maxillary canines. It is important to detect and manage the problem as early as possible, as missing upper incisors are regarded as unattractive, space can be lost and management may be easier in the younger patient.3

Delayed eruption of maxillary central incisors can be classified into two causative groups (Table 1):

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