The management of the dilacerated impacted maxillary central incisor
Keywords:
Unerupted upper central incisor; Dilacerated Maxillary; Orthodontic and pediatric dentistry clinics; Surgical exposure and traction.Abstract
Management of a dilacerated, impacted maxillary central incisor involves an interdisciplinary approach, primarily surgical exposure followed by orthodontic traction to guide the tooth into place, though extraction and prosthetic replacement (implant/bridge) or autotransplantation are alternatives, especially for severe cases, requiring careful planning with imaging like CBCT for precise positioning and management of potential issues like root resorption or ankylosis. Early detection and treatment are crucial for successful outcomes, aiming for functional and aesthetic results....
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Nallanchakrava S, Mettu S, Reddy NG, Jangam K. Multidisciplinary Approach for the Management of Dilacerated Permanent Maxillary Incisor: A Case Report. Int J Clin Pediatr Dent. 2020 Nov-Dec;13(6):725-728. doi: 10.5005/jp-journals-10005-1847. PMID: 33976502; PMCID: PMC8060930.
2,Singh H, Kapoor P, Sharma P, Dudeja P, Maurya RK, Thakkar S. Interdisciplinary management of an impacted dilacerated maxillary central incisor. Dental Press J Orthod. 2018 May-Jun;23(3):37-46. doi: 10.1590/2177-6709.23.3.037-046.oar. PMID: 30088564; PMCID: PMC6072448.
3,Prado N, Malik O, Waring D. The Management of the Dilacerated Impacted Maxillary Central Incisor. Dent Update. 2016 Sep;43(7):618-20, 623-4, 627-8, 630. doi: 10.12968/denu.2016.43.7.618. PMID: 29148672.
4,Xue JJ, Ye NS, Li JY, Lai WL. Management of an impacted maxillary central incisor with dilacerated root. Saudi Med J. 2013 Oct;34(10):1073-9. PMID: 24145944.
5. Tomes, J. (1848) ‘A Course of Lectures on Dental Physiology and Surgery, delivered at the Middlesex Hospital School’, The American journal of dental science, 8(3), p. 209
6. Institution, B. S. (1983) British standard glossary of dental terms. British Standards Institution.
7. Wankhade, A. D. et al. (2013) ‘An endo-aesthetic management of crown dilaceration in a permanent mandibular central incisor’, Case Reports, 2013, p. bcr2012007956.
8. Walia, P. S. et al. (2016) ‘Review of Dilaceration of Maxillary Central Incisor: A Mutidisciplinary Challenge.’, International journal of clinical pediatric dentistry, pp. 90–98. doi: 10.5005/jp-journals-10005-1341.
9. Andreasen, J. O., Andreasen, F. M. and Andersson, L. (2018) Textbook and color atlas of traumatic injuries to the teeth. John Wiley & Sons.
10.ANDREASEN, J. O., Sundström, B. and Ravn, J. J. (1971) ‘The effect of traumatic injuries to primary teeth on their permanent successors: I. A clinical and histologic study of 117 injured permanent teeth’, European Journal of Oral Sciences, 79(3), pp. 219–283.
11. Topouzelis, N. et al. (2010) ‘Dilaceration of maxillary central incisor: a literature review.’, Dental traumatology : official publication of International Association for Dental Traumatology, 26(5), pp. 427–433. doi: 10.1111/j.1600-9657.2010.00915.x.
12. Halazonetis, D. J. (2005) ‘From 2-dimensional cephalograms to 3dimensional computed tomography scans’, American journal of orthodontics and dentofacial orthopedics, 127(5), pp. 627–637.
13.Chew MT, Ong MM. Orthodontic-surgical management of an impacted dilacerated maxillary central incisor: a clinical case report. Pediatr Dent. 2004 Jul-Aug;26(4):341-4. PMID: 15344628.
14.Lu P, Chew MT. Orthodontic-surgical management of an unusual dilacerated maxillary incisor. J Orthod Sci. 2018 Nov 15;7:24. doi: 10.4103/jos.JOS_80_18. PMID: 30547020; PMCID: PMC6251235.
15.Farronato G, Maspero C, Farronato D. Orthodontic movement of a dilacerated maxillary incisor in mixed dentition treatment. Dent Traumatol. 2009 Aug;25(4):451-6. doi: 10.1111/j.1600-9657.2008.00722.x. Epub 2009 Jun 10. PMID: 19519865.
16.Thilander B, Jakobsson SO. Local factors in impaction of maxillary incisors. Am J Orthod. 1968;54(5):355-362.
17.Chaushu, S., Zilberman, Y. and Becker, A. (2003) ‘Maxillary incisor impaction and its relationship to canine displacement’, American journal of orthodontics and dentofacial orthopedics, 124(2), pp. 144–150.
18.Brin I, Becker A, Shalhav M. Position of the maxillary permanent canine in relation to anomalous or missing lateral incisors: a population study. Eur J Orthod. 1986;8(1):12-16.
19.Muhamad AH, Maria A, Watted A, Watted N(2021);. Surgical and Orthodontic treatment of impactionmaxillary central incisor associated with supernumerary. J Dent Sci Res Rev Rep. ;3(1):1-5. DOI:10.47363/JDSR/2021(3)113
20. Watted N., Proff P., Reiser V., Shlomi B., Abu-Hussein M., Shamir D(2015): CBCT; In Clinical OrthodonticPractice: IOSR Journal of Dental and Medical Sciences 2:102-115
21. Azzaldeen A, Mai A, Abu-Hussein M (2017) Geneticsand Dental Disorders - A Clinical Concept. Part;1.IOSR J Dent Med Sci 16(11): 35-42.
22. Watted N, Abu-Hussein M (2014) Prevalence ofImpacted Canines in Arab Population in Israel. IntJPublic Health Res 2(6): 71-77.
23. Abu-Hussein M, Watted N, Azzaldeen A, Yehia M,Awadi O, et al. (2015) Prevalence of Malocclusion andImpacted Canine in Arab Israelian Population(Arab48). Int J Public Health Res 3(5): 180-191.
24. Becker A (2007) The orthodontic treatment ofimpacted teeth. 2nd ed. London, UK: MartinμμμμμDunitzPublishers. pp: 19-140.
25. Watted N, Abu-Hussein M, Hussein E, Proff P.(2015); A dental transposition: literature review and clinical management. J Dent Med Sci. ;14(11):80-5.
26. Nezar Watted, Ali Watted, Muhamad Abu Hussein. Function, Aesthetics, and Strategy: Orthodontic–Orthognathic Concepts in The Treatment of Skeletal Deformities. J Stoma Dent Res. 2025. 3(2): 1-22. DOI: doi.org/10.61440/JSDR.2025.v3.24
27 .Malcangi G, Inchingolo AD, Patano A, Coloccia G, Ceci S, Garibaldi M, Inchingolo AM, Piras F, Cardarelli F, Settanni V, Rapone B. Impacted Central Incisors in the Upper Jaw in an Adolescent Patient: Orthodontic-Surgical Treatment—A Case Report. Applied Sciences. 2022 Mar 4;12(5):2657.
28 .Abdalhussien ZI, Garma NMH. Dilacerated Teeth and there Implication in Orthodontic. 2023.
29 .Sinnott PM, Parker K, Noar J. Management of Bilateral Horizontally Impacted and Dilacerated Maxillary Central Incisors at the Nasal Floor: A Multidisciplinary Specialist Approach. Orthodontic Update. 2021.
30 .Du W, Chi J, He S, Wu G, Pan W, Wang Y, Voliere G, Hu R. The position and morphology characteristics of multiple impacted anterior teeth in the unilateral maxillary area: A retrospective study based on cone-beam computed tomography. American Journal of Orthodontics and Dentofacial Orthopedics. 2022 Dec 1;162(6):907-16.
31 . Pithon MM. Therapeutic approach in Class I malocclusion with impacted maxillary canines. Dental Press Journal of Orthodontics. 2022.
32 .Gul H, Hameedi S, Syed FA, Salahuddin MB, Jawad S, Tauseef Z. Evaluation of Dental Anomalies and its Relationship with Malocclusion and Growth Pattern in Orthodontic Patients Visiting Avicenna Dental Hospital. InMedical Forum Monthly 2021 (Vol. 32, No. 3).
33 .Li Q, Zheng J, Hou B, Hu J et al. Interdisciplinary treatment of an impacted dilacerated maxillary central incisor. AJO-DO Clinical Companion. 2024.
34 Hui J, Niu Y, Jin R, Yang X, Wang J, Pan H, Zhang J. An analysis of clinical and imaging features of unilateral impacted maxillary central incisors: a cross-sectional study. American Journal of Orthodontics and Dentofacial Orthopedics. 2022 Feb 1;161(2):e96-104.
36 .das Neves BM, Junior JC, Artese FR, Canavarro C. Lateral incisor and canine substitutions associated with the extraction of a horizontally impacted maxillary central incisor with root dilaceration. AJO-DO Clinical Companion. 2024 Oct 9.
37.. Cernochova P, Cernoch C, Klimo Kanovska K, Tkadlec E, Izakovicova Holla L. Treatment options for impacted maxillary canines and occurrence of ankylotic and resorptive processes: a 20-year retrospective study. BMC Oral Health. 2024 Aug 2;24(1):877.
38.Abu-Hussein M, Watted N, Yehia M, Proff P, Iraqi F(2015) Clinical Genetic Basis of Tooth Agenesis. JDent Med Sci 14(12): 68-77.
39. Watted A, Azzaldeen A, Watted N, Abu-Hussein M(2018) Management of an Unerupted PermanentMaxillary Incisor: Clinical Case. Int J Dent Med SciRes 2(2): 11-17.
40. NezarW, Emad H, Obaida A, Muhamad AH (2014) Transmigration of Impacted Canines: A Report ofTwo Cases and a Review of the Literature. RRJDS 2: 23-32.
41. Cozza P, Marino A, Condo, R. Orthodontic treatment of an impacted dilacerated maxillary incisor: a case report. J Clin Pediatr Dent Winter 2005 ; 30(2):93-7, .
42. Machtei EE, Zyskind K, Ben-Yehouda A. Periodontal considerations in the treatment of dilacerated maxillary incisors. Quintessence Int 1990; May 21(5):357-60.
43. McNamara T, Woolfe SN, McNamara CM. Orthodontic management of a dilacerated maxillary central incisor with an unusual sequel. J Clin Orthod 1998; 32:293–7.
44. Abu-Hussein M, Abdulgani Azz, Watted N Cleft Lip, Palate. A Comprehensive Review. International Journal of Basic and Applied Medical Sciences. 2014. 4: 338-355.
45. . Watted N, Abu-Hussein M, Bill J, Proff P. Harmonisation of the Dento-Facial Complex A Result of Combination an Orthodontic and Orthognathic Surgical Therapy. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2015. 2: 128-139
46. Watted N, Abu-Hussein M, Bill J, Proff P. Therapeutic Concept by “Watted” for the Surgical Lengthening of the Lower Face by Short Face Syndrome Open Journal of Stomatology, 2015. 5: 127-141.
47. Watted N Proff, P, Reiser V, Benjamin Sh, Abu-Husseinm M, Shamir D. CBCT; In Clinical Orthodontic Practice. IOSR Journal of Dental and Medical Sciences (IOSR JDMS). 2015.
48. Watted N, Abu-Hussein M, Witt E, Proff P, Shlomi B, Festila D. A magnetic resonance imaging studyof the temporomandibular joint and the disc–condyle relationship after functional–orthopaedic treatment. Journal of Dental and Medical Sciences. 2015. 11: 92-103.
49. Watted N, Abu-Hussein M, Watted A, Bill J, Proff P, Schlomi B. Combined orthodontic and maxillofacial surgical treatment: Effect of skeletal changes on soft tissue structures. Journal of Oral Surgery. 2016. 1: 35-42.
50. Abu-Hussein Muhamad. “Aesthetic Correction of Peg Lateral and Diastema, with Resin Composite using Putty Index Technique : A Case Report”. Scholastic Dental Sciences 1.3 (2025): 01-05.
51. Watted N, Ghoul R, Sadiq O, Watted A, Abu Hussein M. Chemico-Biological Approach Accelerating Orthodontic Tooth Movement. Int J Drug Deliv Technol. 2026;16(61s):907-913. DOI:10.25258/ijddt.16.61s.99
52. Abu-Hussein Muhamad etl(2025), Platelet-Rich Plasma in Orthodontics, International Journal of Electrical Power System and Technology, Volume 49 Issue 4 (December ),3430- 44
53. Abu-Hussein Muhamad etl(2025), Role of Stem Cells in Orthodontics International Journal of Electrical Power System and Technology, Volume 49 Issue 4 (December ,2955-79
54. Muhamad Abu Hussein, Nezar Watted. (2025) Biology of Tooth Movement. Int Dent Jour. ;4(4):1-14. (4):458–68.
55. Abu-Hussein Muhamad., et al. (2025): “Analgesics and Orthodontic Tooth Movement". Acta Scientific Dental Sciences 9.6 30-43.
56. Watted N., et al. (2014): “Influence of drugs on orthodontic tooth movement”. Journal of Research inMedical and Dental Science 2.4 : 9-16.
57. Omar Sadiq, Rand Ghoul , Nidal Ghannam and Abu-Hussein Muhamad, (2025) Effect Of Hormone on Orthodontic Tooth Movement: A Review. Journal ofNeonatal Surgery, 14 (22s), 189-201.
58. Azzaldeen A, Qawasmeh Nour, Abdulgani Mai, et al. Multidisciplinary Approach for Management of Congenitally Missing Lateral Incisors - 10 Year Follow-up: A Case Report. Discov. Dental Res. Rev. Rep. 2024; 1: 1-5.
59. Nour Qawasmeh, Mahran Abu Serriya, Abu-Hussein 1. Muhamad, (2025) Artificial intelligence in oral medicine. Journal of Neonatal Surgery, 14 (13s), 878-890
60. Muhamad AH., 2025, Biomechanics in Orthodontic 3. Treatment. Mega J Case Rep. ;8(6):2001-2004.
61. Abu-Hussein Muhamad (2025) Odontogenesis and Tumorigenesis. J Dent Maxillofac Med 1: 1-4..
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