A Retrospective Study of Dilacerated Maxillary Central Incisors

Abstract

Aim: The purposes of this investigation were to gather the general information about dilacerated maxillary incisors and to analyze the treatment outcomes retrospectively. Materials and Methods: Twenty eight children (29 maxillary central incisors) diagnosed with dilacerated incisors were selected. The average age was 9 years and one month old. Clinical investigation included sex difference, quadrant affected, trauma history, midline shift, and treatment methods. Cephalometric analysis used crown root axis angle (CRAA) and crown axis inclination angle (CAIA) for measuring the position and severity of the dilacerated incisor. Treatment alternatives including orthodontic traction, extraction followed b orthodontic alignment and resin-bonded bridge restorations, and extraction followed by orthodontic space rearrangement were evaluated to find the possible relationships with CRAA and CAIA. Results: No obvious sex difference and position preference shown in these cases. Only one case had an obvious traumatic history of the maxillary anterior region. Space analysis of upper arch showed a significant midline shift toward the non-eruption side. Regarding treatment modalities, the results concluded that cases with CRAA＜90o and CAIA＞100o tended to extract the dilacerated teeth and restore with a resin-bonded bridge, in contrast, cases with CRAA≧90o and CAIA≦100o, the dilacerated incisors could be successfully positioned through orthodontic traction. Conclusion: The use of CRAA and CAIA is proven to be an effective way of evaluating dilacerated incisors clinically. Further study by using computer tomogram with 3-D image might be a good solution for tracing better root images in the maxillary anterior region.