Orthodontic management in a female patient with an impacted incisor in the mandible – case report

Traumas to deciduous teeth, such as intrusion and complete

avulsion, lead to the most severe injuries to tooth buds of

permanent teeth. The most common post-traumatic

complications of permanent teeth include: enamel hypoplasia

or hypocalcification, crown or root dilaceration, partial or

complete inhibition of root growth, and eruption disorders.

Aim. The paper aimed to present orthodontic treatment in

a female patient with an impacted permanent lower incisor

with significantly impaired morphology due to a trauma to

its deciduous predecessor. Material. Material included:

patient’s orthodontic records, gypsum models, photographs

and radiological records. Results. Orthodontic treatment

was successful despite abnormal morphology of the impacted

tooth 41. After 4-year follow-up the tooth remains in the

arch. Conclusions. A tooth can be preserved in the socket

when the crown-to-root ratio (CRR) is at least 1 : 1. In this case, CRR for the tooth 41 was 2 : 1, and therefore its

extraction would be recommended. Despite this a decision

was made to introduce an impacted tooth into the arch.

Thanks to its presence in the dental arch it was possible to

preserve appropriate bone quality for implantation of a prosthetic

implant in the future. Prosthetic treatment (if necessary)

may be performed after completion of vertical growth of the

face that is observed in women after the age of 16 years.

Summary. This case of a 15-year female patient shows that

as a result of orthodontic and surgical intervention and

despite significant root shortening the tooth may remain in

the dental arch and play its functional and aesthetic role.

(Świątkowska A, Dunin-Wilczyńska I, Świątkowski W.

Orthodontic management in a female patient with an

impacted incisor in the mandible – case report. Orthod

Forum 2018; 14: 150-7).