Unveiling the impacted incisor

Abstract

Missing and unerupted maxillary incisors can have a major impact on dental and facial esthetics and were considered to be the most unattractive deviant occlusal trait. There are very few studies reporting any functional problems associated with the missing anterior teeth although some speech difficulties have been reported, particularly with the s sound. Although impaction of permanent tooth is rarely diagnosed during the mixed dentition period, an impacted central incisor is usually diagnosed accurately when there is delay in the eruption of tooth. As missing upper incisors are regarded as unattractive, this may have an effect on self-esteem and general social interaction and it is important to detect and manage the problem as early as possible. This case report describes the treatment of a patient with a horizontally impacted maxillary central incisor. Due to a midline shift and lack of space in the upper arch, a two stage treatment plan was developed. In the first stage, space was created by using a closed coil spring. The second stage involved surgical exposure and traction of the impacted central incisor. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches and an adequate width of attached gingiva.