Orthodontic and periodontal considerations in maxillary central incisor impactions: Case series

Abstract

• Knowing the etiology, location, and degree of root formation is important. • An interdisciplinary orthodontic-surgical approach is needed. • Early treatment can facilitate the natural emergence of these teeth. • Impacted maxillary central incisor management can be efficient and effective. • Biomechanical and surgical planning leads to a long-term, stable, and functional result Maxillary central incisors are essential for mastication, smiling, and phonetics. When impacted, they generate a major orthodontic challenge that is better to be addressed as soon as possible. These impactions can be caused by early trauma or physical obstruction in the eruption pathway by odontomas or supernumerary teeth.Pediatricians, pedodontists and caregivers are usually the first ones to discover a problem and recommend an orthodontic evaluation. Four patients are presented with documentation during active therapy and the retention period. Impaction etiology, surgical exposure techniques, treatment mechanics, periodontal considerations, soft-tissue management, and possible root formation complications should be discussed in a multidisciplinary setting. A stable, esthetic, and functional outcome can be achieved if maxillary central incisor impactions are diagnosed correctly and treated accordingly. Long-term follow-up is presented to understand periodontal changes over time in these patients. Literature related to impacted maxillary central incisors is discussed for a holistic assessment.