ORTHODONTIC AND/OR PHYSIOLOGIC POSITIONING OF IMPACTED MAXILLARY CENTRAL INCISORS

매복 상악 중절치의 교정적 처치에 관한 임상 증례

It is a relatively common clinical experience to see a impacted maxillary central incisor. This is apparent at the dental age of about eight years and over, when the patient is in the early mixed dentition stage. The adjacent teeth may tilt toward the site of the missing tooth with resulting space closure and midline deviation. Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. Each of the current articles describing labial impactions shows at least one case with mucogingival recession or a minimal zone of attached gingiva. This report described the surgical uncovering and orthodontic-physiologic positioning methods with labially impacted maxillary central incisors. Through surgical exposure and direct bonding of lingual botton, the central incisors were brought into proper eruption path with elastic traction. The case 1 and 2 were treated with the physiologic erupting forces. The case 3 was applied with continuous orthodontic force. The case 1 and 2 resulted in good positioning, good esthetics and adequate width of keratinised gingiva. The case 3 resulted in local inflammation and inadequate width of keratinised gingiva.