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Management of Unerupted
Maxillary Incisors
Omar Yaqoob
BDS MFDSRCS MSc MOrthRCS
FDSRCSEd FHEA
Specialist Orthodontist
Specialist Practice
Julian O’Neill
BDS MSc FFDRCSI MOrthRCS
Consultant Orthodontist
Maxillofacial Unit
Kettering General Hospital
Northants NN16 8UZ
Shruti Patel
BDS FDSRCS MSc MOrthRCS
FDSOrthRCS
Consultant in Orthodontics
King’s College Hospital NHS Trust
London SE5 9RS
Jadbinder Seehra
BDS(Hons) MFDSRCS MSc MOrthRCS
FDSOrthRCS
Consultant Orthodontist and Hon Clinical
Senior Lecturer, Department of Orthodontics
King's College London Dental Institute
London SE1 9RT, UK
Catherine Bryant
BDS FDSRCS MSc
Consultant in Oral Surgery
Department of Oral Surgery
King's College Hospital Dental Institute
Denmark Hill, London SE5 9RW
Joe Noar
MSc BDS FDSRCS(Ed) FDSRCS(Eng)
DOrthRCS(Eng) MOrthRCS(Eng) FHEA
Consultant/Hon. Senior Lecturer
Orthodontic Unit
Division of Craniofacial & Development
Sciences
Eastman Dental Hospital/Institute
256 Gray's Inn Road
London WC1X 8LD
Terry Gregg
FDSRCPS, FDSRCS, FFDRCSI
Consultant in Paediatric Dentistry
Barts Health Dental Hospital
Turner Street
London E12AD
David Morris
BDS FDSRCS FDSOrthRCPS MSc
MOrthRCS
Consultant in Orthodontics
Department of Orthodontics
Leeds Dental Institute
Leeds, LS2 9LU, UK
Martyn T.Cobourne
FDSRCS, FDSOrthRCS, PhD
Professor and Hon Consultant in
Orthodontics
Department of Orthodontics
King's College London Dental Institute
LONDON SE1 9RT
Management of Unerupted Maxillary Incisors
i
Contents
Introduction .............................................................................................................................................................................. 1
1 Diagnosis and management ......................................................................................................................................... 1
1.1 Definition ............................................................................................................................................ 1
1.2 Causes of delayed eruption ............................................................................................................... 1
2 Incidence and prevalence ............................................................................................................................................. 1
3 Establishing the cause of eruption failure ................................................................................................................. 1
3.1 Medical and dental history ................................................................................................................. 1
3.2 Clinical examination ........................................................................................................................... 2
3.3 Radiographic examination ................................................................................................................. 2
4 General principles of management ............................................................................................................................ 2
4.1 Patient factors .................................................................................................................................... 2
4.2 Dental factors ..................................................................................................................................... 3
5 Management options ..................................................................................................................................................... 4
5.1 Removal of a physical obstruction ..................................................................................................... 4
5.2 Removal of the obstruction only ........................................................................................................ 4
5.3 Surgical intervention(s) ...................................................................................................................... 4
5.4 Incisor removal .................................................................................................................................. 6
5.5 Ankylosed maxillary incisors .............................................................................................................. 6
5.6 Autotransplantation ............................................................................................................................ 6
5.7 Monitoring of further dental development .......................................................................................... 6
Recommendations .................................................................................................................................................................. 6
References ................................................................................................................................................................................ 7
Management of Unerupted Maxillary Incisors
1
Introduction
1 Diagnosis and management
1.1 Definition
1.2 Causes of delayed eruption
2 Incidence and prevalence
½
3 Establishing the cause of eruption failure
3.1 Medical and dental history
Management of Unerupted Maxillary Incisors
2
3.2 Clinical examination
3.3 Radiographic examination
4 General principles of management
4.1 Patient factors
4.1.1 Medical history
Management of Unerupted Maxillary Incisors
3
4.1.2 Age
4.1.3 Compliance
4.2 Dental factors
4.2.1 Retained primary teeth
4.2.2 Position of the impacted incisor
4.2.3 Developmental stage of the impacted
incisor
4.2.4 Nature of any physical obstruction to
eruption
4.2.5 Unfavourable root formation
Management of Unerupted Maxillary Incisors
4
5 Management options
5.1 Removal of a physical obstruction
5.2 Removal of the obstruction only
5.2.1 Removal of the obstruction with creation
of space
5.3 Surgical intervention(s)
Management of Unerupted Maxillary Incisors
5
5.3.1 Open exposure
5.3.2 Closed eruption technique
5.3.3 Open versus closed eruption techniques
Management of Unerupted Maxillary Incisors
6
5.4 Incisor removal
5.5 Ankylosed maxillary incisors
5.6 Autotransplantation
5.7 Monitoring of further dental development
Recommendations
Management of Unerupted Maxillary Incisors
7
References
Management of Unerupted Maxillary Incisors
8
Management of Unerupted Maxillary Incisors
9
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