Εvaluation of a treatment protocol for unerupted maxillary central incisors: retrospective clinical study of 46 children

Aim To evaluate the clinical outcome of a treatment protocol performed in children with unerupted permanent maxillary central incisors, including surgical removal of any related obstruction and traction initiation in one stage, under fully repositioned flap, combined with pre- and post-operative orthodontics for space creation and final alignment. Methods Forty-six patients aged 7.3–12.7 years (mean = 9.44 ± 1.36) having 54 impacted maxillary central incisors were reviewed. The study group included 37 patients fully treated by us and nine referrals with eruption failure of impacted incisors following previous surgical removal of various obstructions. Detailed patient’s clinical and radiographic data were recorded. Results Aetiology of unerupted incisors included 9 patients with odontomas, 24 with supernumerary teeth, 1 with skeletal lack of space, 1 with a dentigerous cyst, 4 with dilaceration, 1 with severe incisor MIH, 5 with luxation injuries to primary predecessors and 1 with coexisting dilaceration and odontoma. The total treatment time following the standardised protocol ranged from 5 to 21 months (mean 9.88 ± 3.10), while the time needed using different approaches (no pre-operative orthodontics or obstruction removal and then to wait over an assessment period) ranged from 12 to 18 months (mean 15 ± 2.12) and 17 to 30 months (mean 23.73 ± 5.14), respectively ( p