Lee K J, Hur J, Kim H, Seo M H
Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
Department of Pediatric Dentistry, Seoul National University Dental Hospital, Seoul, Republic of Korea.
Eur Arch Paediatr Dent. 2025 Jul 4. doi: 10.1007/s40368-025-01076-9.
Inverted impaction of the maxillary central incisors is a rare condition, typically associated with adjacent impacted supernumerary teeth, odontomas, root dilaceration, or inadequate eruption space. Treatment options include surgical repositioning, orthodontic traction, or extraction. This retrospective study evaluated the long-term outcomes of patients treated with surgical repositioning.
Patient age at the initial visit, sex, etiologic factors contributing to impaction, follow-up duration, spontaneous eruption to the occlusal plane, degree of root development, and complications such as root resorption, delayed or arrested eruption, and pulp necrosis were assessed through electronic medical records and radiographic evaluations. A total of five patients were included, with an average follow-up of 47.8 months (range 34-59 months). All repositioned teeth successfully erupted into the occlusal plane. One patient had bilateral inverted impaction and required orthodontic treatment after eruption. Another patient, who exhibited root dilaceration preoperatively and underwent repositioning at a more advanced stage of root development, developed pulp necrosis and required root canal treatment.
Surgical repositioning offers the advantage of facilitating normal root development in inverted impacted maxillary central incisors. To minimize surgical complications, careful technique, gentle handling, and minimal surgical time are critical. Long-term follow-up is essential for monitoring treatment success.
上颌中切牙倒置阻生是一种罕见的情况,通常与相邻的阻生多生牙、牙瘤、牙根弯曲或萌出空间不足有关。治疗选择包括手术复位、正畸牵引或拔除。这项回顾性研究评估了接受手术复位治疗的患者的长期疗效。
通过电子病历和影像学评估,对患者初诊时的年龄、性别、导致阻生的病因、随访时间、自发萌出至咬合平面的情况、牙根发育程度以及诸如牙根吸收、萌出延迟或停滞、牙髓坏死等并发症进行了评估。共纳入5例患者,平均随访47.8个月(范围34 - 59个月)。所有复位的牙齿均成功萌出至咬合平面。1例患者为双侧倒置阻生,萌出后需要正畸治疗。另1例患者术前表现为牙根弯曲,在牙根发育更成熟阶段接受复位治疗,发生了牙髓坏死,需要根管治疗。
手术复位具有促进倒置阻生上颌中切牙正常牙根发育的优势。为将手术并发症降至最低,谨慎的技术操作、轻柔的处理以及最短的手术时间至关重要。长期随访对于监测治疗成功与否必不可少。