Surgical repositioning of an impacted dilacerated incisor in mixed dentition

Treatment options for a dilacerated incisor are either extraction or surgery and orthodontic traction. Because patients with such incisors usually are young, and because of the root angulation of the impacted incisor, treatment usually is lengthy and complicated. Surgical repositioning provides another option for treatment of this unique problem.

The author presents the case of a 9-year-old girl with an impacted dilacerated maxillary central incisor to demonstrate the timing, technique and results of the surgical repositioning treatment approach. The advantages of this approach include immediate esthetic improvement, use of a single and simplified surgical procedure, simple and short orthodontic therapy, a normal gingival margin and the possibility of the developing root's adapting to the new position.

Surgical repositioning is a simplified treatment for dilacerated incisors. It is especially valuable in cases of difficult-to-treat impaction. Timing of surgical repositioning depends on the incisor's root development and the space available for the transplant.