Abstract
The inclusion of the maxillary incisors, although rare, poses even more difficulty to the practitioner who diagnoses it. This difficulty is increased in front of an angulated incisor in a labial position with the “policeman's sign”, the prognosis of orthodontic therapy being reserved.This article aims to describe a clinical case of retention of two maxillary central incisors with radicular angulation and in a vestibular position in an 11-year-old adolescent, referred in the Rabat dental consultation and treatment center. clinically, we can note the absence of the two maxillary central incisors on the dental arch, confirmed by the X-ray with the presence of obstacles on the path of the incisors which are in a very high position with angulated roots. The challenge was to put on the arch of the teeth and especially the aesthetic challenge. The satisfactory result obtained is only the result of the motivation of the patient as well as the dexterity of the practitioner. Despite the current treatment, we are comforted in our choice to treat. it is obvious for us that the only absolute contraindication to traction in the case of an impacted incisor remains dilaceration
Highlights
According to the French Orthodontic Society, a tooth is considered to be included when it is retained with its follicular sac without communication with the oral cavity at least 2 years after its normal eruption date
Only the structural abnormality allows the practitioner to make the diagnosis, the importance of X-rays to look for the characteristic signs of dilaceration
The case described presents two angled maxillary incisors impacted with the presence of odontomas
Summary
According to the French Orthodontic Society, a tooth is considered to be included when it is retained with its follicular sac without communication with the oral cavity at least 2 years after its normal eruption date. Its management requires an overall plan integrating the final periodontal result. The practitioner must anticipate the final result from the aesthetic point of view, which requires a collaboration with the surgeon. The difficulty of therapeutic decision is all the more important when the impacted incisor presents a strong angulation with or without anomaly of the crown structure, it is a question of "angulated" or "dilacerated" teeth. For a precise aetiological and morphological diagnosis in order to define the prognosis, the preoperative prescription of 3D imaging such as cone beam CT scan (CBCT) or CT Dentascan, is recommended to specify the external morphology and structural defects of the impacted incisor, which certainly helps to establish an appropriate treatment plan. Intervention will be indicated when the contralateral tooth has already erupted
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