Interdisciplinary management of an impacted dilacerated maxillary central incisor

ABSTRACT Introduction: Tooth dilacerations are dental anomalies characterized by an abrupt deviation in the longitudinal axis of a tooth. They may occur either in the crown, between the crown and root, or in the root. Although not so common, impacted maxillary incisors exhibiting root dilaceration pose a diagnostic and treatment challenge to the clinician. Description: This case report describes the management of a horizontally impacted and dilacerated maxillary central incisor in a 12-year-old girl. Cone-beam computed tomographic scans were used to accurately localize the position of the dilacerated tooth, and to assess the extent of root formation and degree of dilaceration present in the root. Treatment included surgical exposure and orthodontic traction, followed by root canal treatment and apicoectomy. Results: Through a meticulously planned interdisciplinary approach, the impacted dilacerated central incisor was properly aligned and demonstrated good stability after the long-term follow-up. Conclusion: Taking into consideration the concerns and expectations of the patient, communicative feedback between the oral surgeon, orthodontist and endodontist helped achieving successful esthetic, structural and functional outcome in the present case.摘要 引言：牙根弯曲（tooth dilacerations）是一类以牙齿长轴突发偏离为特征的牙体发育异常，可发生于牙冠、冠根交界区域或牙根部位。尽管此类病症并不多见，但伴牙根弯曲的阻生上颌切牙仍会给临床医师带来诊断与治疗挑战。 病例描述：本病例报告阐述了1例12岁女童的水平阻生且伴牙根弯曲的上颌中切牙的诊疗经过。临床采用锥形束计算机断层扫描（cone-beam computed tomographic，CBCT）精准定位患牙位置，并评估牙根发育程度与牙根弯曲的严重程度。治疗方案涵盖手术暴露、正畸牵引，随后实施根管治疗与根尖切除术。 结果：通过精心规划的多学科协作诊疗模式，该阻生伴牙根弯曲的中切牙得以正确排齐，且在长期随访中表现出良好的稳定性。 结论：结合患者的诉求与预期，口腔外科医师、正畸医师与牙髓专科医师之间的有效沟通与协作，助力本病例取得了理想的美学、结构与功能预后效果。