Surgical repositioning of inverted maxillary central incisors in children: a long-term retrospective case series analysis.

Abstract

Purpose: Inverted impaction of the maxillary central incisors is a rare condition, typically associated with adjacent impacted supernumerary teeth, odontomas, root dilaceration, or inadequate eruption space. Treatment options include surgical repositioning, orthodontic traction, or extraction. This retrospective study evaluated the long-term outcomes of patients treated with surgical repositioning.

Case series description and results: Patient age at the initial visit, sex, etiologic factors contributing to impaction, follow-up duration, spontaneous eruption to the occlusal plane, degree of root development, and complications such as root resorption, delayed or arrested eruption, and pulp necrosis were assessed through electronic medical records and radiographic evaluations. A total of five patients were included, with an average follow-up of 47.8 months (range 34-59 months). All repositioned teeth successfully erupted into the occlusal plane. One patient had bilateral inverted impaction and required orthodontic treatment after eruption. Another patient, who exhibited root dilaceration preoperatively and underwent repositioning at a more advanced stage of root development, developed pulp necrosis and required root canal treatment.

Conclusion: Surgical repositioning offers the advantage of facilitating normal root development in inverted impacted maxillary central incisors. To minimize surgical complications, careful technique, gentle handling, and minimal surgical time are critical. Long-term follow-up is essential for monitoring treatment success.