Orthotown September 2019 - 22
message board
Impacted Central Incisor
A relatively familiar instance of move or remove turns into a case where
a CBCT may hold the right answer ... and one the doc didn't consider
DEFOrtho
Member Since: 01/11/10
Posts: 1 and 6 of 10
My question is would you try to bring in impacted tooth #9 or have it removed? What is your
reasoning for either way? Thanks for your insight and advice. ■
7/9/2019
justinudm
Member Since: 09/29/14
Post: 5 of 10
Ideally, you would want to try to bring that tooth in, but I think you need more information.
I would send the patient to get a maxillary cone beam to look at the root of that impacted incisor.
If you look at the ceph, it appears the root has a significant curve on it, then you couple this with
the pan, and I think this root may have a distal lingual bend to it. I would confirm this with a
CBCT before agreeing to try to move this tooth. But if it has got a "fish hook" root on it, it may be
better to just have it removed and plan for an implant later...so tell the patient and parent that on
review of the current X-rays. I think we need a 3D X-ray to determine the best course of action. ■
7/10/2019
whiskeyriver
Member Since: 02/05/13
Post: 7 of 10
What have you got to lose? Myself and others have brought in cuspids in worse positions. I
bet you have, too. I don't see his age, but he looks to be in his teens, too young for an implant
now. You would have to hold the space with a bonded lingual retainer on both sides of the
edentulous space along with a flipper of some sort if you snatch #9. Not sure where you are, but
resin bonded bridges around here have about a two to three-year life span. Besides, a tooth from
a box (implant) has its long-term limitations like gingival recession. What will the tissue around
that implant look like 20 years from now? If you have your doubts, discount the fee and make it
a teaching case for yourself. You and the patient will be rewarded to be sure. ■
7/22/2019
This central incisor case centers in on the
power of perspective. Will a CBCT unlock
the course for the best treatment?
Follow this case as it develops. You might even learn a thing or two! Search
"Impacted Central" at orthotown.com/messageboard and this will be
among the top results.
22
SEPTEMBER 2019 // orthotown.com
https://www.orthotown.com/Search.aspx?q=impacted+central
http://www.orthotown.com
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