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Article: Volume 43 Number 7 Page 618 - September 2016

  Dent Update 2016; 43: 618-630  Read article

Oral surgery:  The Management of the Dilacerated Impacted Maxillary Central Incisor

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Abstract: The clinical problem of how best to manage a dilacerated, impacted maxillary central incisor will only be encountered rarely. The treatment aim should be to achieve results that are indistinguishable from normal appearance in a way that is appropriate for the patient. This article discusses the incidence of dilacerations in maxillary incisors and describes the treatment approaches available − orthodontic alignment or surgical removal and management of the resulting space, considering orthodontic repositioning, autotransplantation and various prosthetic replacements. Treatment indications, advantages and disadvantages, restorative and surgical implications, as well as the evidence-base relating to the various treatment modalities will be presented, along with clinical case examples.

Clinical relevance: This paper discusses a problem that, if not managed appropriately, can lead to poor results for the patient. Even for practitioners who may not undertake the treatment mentioned, it will enable them to have more in-depth discussion with their patients should the situation arise.

Author notes: Naomi Prado, BSc(Hons), BDS, MFDS RCPS(Glas), DCT1 in Oral Surgery, Paediatrics and Orthodontics, (n_prado@live.co.uk), Ovais Malik, BDS, MSc, MFDS RCS(Ed), MOrth RCS(Eng), MOrth RCS(Ed), FDS(Orth) RCS(Eng), Consultant in Orthodontics and David Waring, BDS, MSc, MFDS RCS(Ed), MOrth RCS(Ed), FDS(Orth) RCS(Eng), Consultant in Orthodontics, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK.

Objective: To recognize the causes of dilacerations in maxillary central incisors and understand the different treatment options available.