Management of Impacted Maxillary Central Incisor: A Case Report

Abstract

Background
Impaction of maxillary permanent incisors is not a frequent case in the dental practice, but its treatment is challenging because of these teeth’s importance to facial aesthetics. Over-retained deciduous teeth, supernumerary teeth, ectopic eruption and crowding are the most common etiological factors. Careful planning and interdisciplinary approach are required for its management.

Case Description
A 22 years old male patient presented with the chief complaint of missing upper front tooth. The patient had no any history of medical problem and dental trauma. Intra oral examination revealed absence of 11. 12 21 22 were erupted. There was no apparent arch length discrepancy in both arches. No soft tissue bulging was present. OPG revealed impacted 11 along with the presence of odontome. Treatment plan included surgical removal of odontome and orthodontic traction of 11. After completion of alignment and levelling in upper arch, full thickness mucoperiosteal flap was raised followed by removal of odontome and bonding of lingual button on palatal aspect of 11. One week later orthodontic traction was started. After 4 months, 11 erupted into oral cavity. Lingual button was bonded on labial surface of 11. Couple force was applied for rotation correction. Bracket was bonded on 11 and traction was continued with 0.012 NiTi archwire.

Conclusion
Successful management of impacted central incisor is a clinical challenge. Early detection and exact localization of the impacted tooth, an appropriate surgical technique, and a light orthodontic force system can be an effective approach to successfully bring the tooth into occlusion.