Impacted central incisors: factors affecting prognosis and treatment duration

In this study, we aimed to assess the patient and treatment factors that influence the success rate and the duration of the orthodontic-surgical modality for impacted central incisors.

The records of 60 consecutively treated patients (64 impacted incisors) were retrospectively evaluated. The success rate and the duration of each stage of treatment were examined in relation to age, sex, etiology of impaction, location of the impacted tooth, and type of surgical exposure performed. Logistic regression analyses were applied.

The group consisted of 26 male and 34 female subjects, 7.0 to 21.9 years old; 27 patients had impactions because of root dilaceration, 29 had impactions because of obstruction, and 4 had impactions with unknown causes. The overall success rate was 90.0%. Five of the 6 failures were dilacerated incisors. The average duration of treatment was 21.6 ± 8.7 months. The only factor that significantly increased the duration was the height of the impacted tooth. Dilaceration was related to a longer stage of traction and, in older patients (late mixed and full permanent dentition), to a longer finishing stage.

The orthodontic-surgical treatment of impacted incisors is generally successful, but relatively long. Patients and parents should be warned of the risk of failure and the increased treatment duration, especially for dilacerated incisors impacted high in the alveolus.