Impacted Maxillary Central Incisors

Abstract

Any significant delay in eruption of the maxillary central incisor teeth needs careful management as presenting patients are usually young and may not have had any previous dental experience. Treatment will depend on many variables including the age and compliance of the patient, aetiology of impaction, position of the impacted tooth, the potential need to recreate space, appropriate surgical intervention and possible guided tooth eruption with orthodontic traction. Following clinical and radiographic assessment, an accurate diagnosis of the problem is required. A favourable outcome is achieved in the majority of cases, although alignment of dilacerated incisors and those impacted high in the alveolus are more challenging. Ideally, by the time an individual starts secondary school, both upper central and lateral incisors should have erupted, affording dental, functional, aesthetic and psychosocial benefits to the patient. Specific clinical guidelines for the management of impacted maxillary incisors are available in the UK (https://www.rcseng.ac.uk/fds/publications-clinical guidelines/clinical_guidelines/documents/ManMaxIncisors2010.pdf).