• The korean journal of orthodontics
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• v.37 no.2 s.121
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• pp.159-163
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• 2007

Impaction with a severely dilacerated root is seldom reported, especially in the maxillary incisor. It is probably because of the high clinical difficulty associated with bringing the dilacerated tooth into proper position, and the high chance of failure due to ankylosis, external root resolution, and root exposure after orthodontic traction. Even the successful cases may need periodontal surgery to improve the unesthetic gingival shape. However, it has previously been reported that an impacted maxillary central incisor was successfully treated by proper crown exposure and orthodontic traction. This article presents a case of an invertedly impacted maxillary right central incisor with a developing dilacerated root, which was aligned into proper position after orthodontic traction composed of two stages of a closed eruption technique.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.334-343
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• 2018

The purpose of this study was to investigate the cause of eruption disturbance in the maxillary central incisor and establish the effective treatment plan by analyzing the vertical distance, angulation of long axis and root development of the tooth with eruption disturbance using the cone-beam CT. The average age of 134 patients diagnosed with unilaterally impacted maxillary central incisor was 7.9 years old and the male was 2.1 times higher than the female. The most common cause of eruption disorder was physical obstruction, especially mesiodens and odontoma. Of the teeth with unilateral eruption disorder, 78 cases erupted spontaneously and 56 cases erupted non-spontaneously after removal of physical obstruction. The possibility of spontaneous or non-spontaneous eruption in the unilaterally impacted maxillary central incisor depended on several factors, such as vertical distance, angulation of long axis and root development of unerupted tooth. The spontaneous eruption of the impacted maxillary cental incisor was most frequent at the angulation of long axis of 50 to 90 degrees, which is similar to the angulation of long axis of the normally erupted maxillary central incisor. In addition, the spontaneous eruption period of impacted maxillary central incisor was more influenced by the vertical distance than the angulation of long axis and the root development. Most of the teeth that showed non-spontaneous eruption had orthodontic traction, and these teeth were usually erupted within about 12 months. The period treated with orthodontic traction was no statistical significance with the vertical distance, the angulation of long axis, and the root development. This study will provide information on the cause of unilaterally impacted maxillary cental incisor and help to establish the future treatment plan.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.383-390
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• 2001

It is a relatively common clinical experience to see a impacted maxillary central incisor Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. The labial impactions have been found to be associated with mucogingival recession, reduced attached gingiva and periodontal pockets. For the successful treatment, clinicians should avoid loss of attached gingiva in surgical exposure. The most common methods of uncovering labially impacted maxillary anterior teeth are gingivectomy, apically positioned flap and closed eruption technique. If gingivectomy will not leave enough attached gingiva, then an apically positioned flap may be the treatment of choice. If the tooth is impacted in the middle of the alveolus or high in the vestibule near the nasal spine, the closed eruption technique may be the treatment of choice. Closed eruption technique was used in one case, apically positioned flap was used in two case. As the result in two cases of impacted maxillary central incisor, apically positioned flap provide the adequate width of attached gingiva. In case of impacted maxillary central incisor, through the clinical and radiologic examination to select correct surgical operation for reduce the complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.550-556
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• 2005

Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, transplantation and extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.510-517
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• 1994

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.

• The Journal of the Korean dental association
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• v.16 no.1 s.104
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• pp.37-42
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• 1978

A study on the impacted teeth of the anterior segment was carried out. The data for this study were compiled form 1739 outpatients of the Department of Orthodontics, College of Dentistry, Seoul National University. The following conclusions were obtained; 1. The frequency of the impacted teeth of the anterior segment was 2.8% and the frequency of male was 4.0%, that of female was 2.1%., respectively. 2. The order of occurrence of the impacted teeth in the anterior segment was maxillary canine mesiodens, maxillary central incisor, maxillary lateral incisor, mandibular canine. 3. The etiologic factors of the impaction were the space deficiency for eruption, cleft palate, the prolonged retention of deciduous teeth, dentigerous cyst. 4. The favorable results of treatment and prognosis were obtained from the impacted teeth of the normal shape after surgical exposure and adhered the plastic attachment and inducted them into the dental arch.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.727-733
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• 1997

Autotransplantation is a procedure which transplants teeth from the original position to other positions in the same individual. It is classified surgical reposition by intraalveolar autotransplantation and transalveolar autotransplantation. The prognosis for successful autotransplantation is dependent on a number of factors such as root development, surgical technique, patient's age, endodontic treatment, time and type of splinting, preservation of periodontal ligament and storage medium. The most important factor is preservation of periodontal ligament. The cause of the failure of transplantation include damage of the transplant during removal from deep palatal malposition, poor regeneration of the bone around the transplant and chronic periodontal infection. In case I, Impacted maxillary canine for which surgical exposure and orthodontic treatment was impossisle was transplanted. After 2 weeks, It showed periapical radiolucency and external root resorption. So, endodontic treatment was done. One year later, permanent filling was done with gutta percha. In case II, Transpositioned maxillary central incisor was transplanted after extraction of impacted mesiodens. Pulp vitality was maintained during 5 months without other clinical symptons.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.757-765
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• 2008

Maxillary central incisor impactions occur infrequently. Their origins include various local causes, such as odontoma, supernumerary teeth, space loss, and disturbances in the eruption path, also trauma and apical follicular cysts. Impacted teeth can cause serious dental and aesthetic difficulties as well as psychological problems especially in anterior regions. Although the impaction of maxillary incisor occurs less frequently than that of the maxillary canine, it is of concern to parents during the early mixed dentition stage because of the uneruption of the tooth. Forced eruption of impacted teeth should be considered in young patients because this technique can lead to suitable results from a periodontal, occlusal, and esthetic perspective at an earlier stage better than with other treatment options. This report presents the surgical and orthodontic treatment of cases with horizontally impacted and dilacerated maxillary central incisors. For each patient, we used the closed eruption method, placed an attachment on the impacted tooth on surgery, and fully closed the flap. Traction was applied immediately. The impacted tooth erupts through the healed tissue in a manner resembling normal eruption.

• The korean journal of orthodontics
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• v.4 no.1
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• pp.57-61
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• 1974

The patient, a girl of 19 years in good health, had a class I malocclusion. The maxillary left centra1 incisors and both lateral incisors had already erupted. But the space for the right central incisor was partially closed by the mesial drifting of the neighboring teeth. The caused a shift in the midline and a cross-bite relation on the incisors. X-ray examination revealed the presence of the right central incisor in the alveolar bone and odontoma just above the crown of the right central incisor. After enough space for the impacted incisor was created in the dental arch with a open-coil spring the rectangular incision was made. Removing the odontoma uncovered the flat surface of the labial aspect of the incisor. During the tooth had erupted of its own accord, any unnecessary force had been imposed on the tooth. When it was decided that the tooth should be brought out by the mechanical device, the gold cast onlay with hook was used and run a light elastic between this hook and the main arch wire. Finally the tooth was brought down to the arch level. The result was excellent. Fortunately the esthetic problem and any detrimental effects on the psychological make-up could be avoided.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.1-9
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• 2018

The purpose of this study is to identify the factors affecting the treatment outcome after surgical-orthodontic treatment of the maxillary impacted incisors using multiple regression analysis. The study enrolled 83 patients who had surgical-orthodontic treatment in impacted maxillary central incisor between January 2005 and December 2015. Possible explanatory variables related to the prognosis of impacted incisor were age, gender, tooth developmental stage, height, position and angle of the teeth. The results of multiple regression analysis showed that as the height of the stem cell from apical papilla (SCAP) increased, the tooth length ratio increased by 0.345 units (p < 0.01). There was no statistically significant difference in gender, tooth development stage, distance and angle between the center line and the tooth, and the height of incisal tip of the tooth. In conclusion, the height of the SCAP of the impacted central incisor is factor affecting the tooth length after orthodontic traction.