Redirecting root development in dilacerated inverted incisors: A two-case series of early treatment

Treatment of an inverted central incisor with dilaceration is challenging for clinicians because of its complicated anatomy and abnormal position. Herein, we present two cases of early orthodontic treatment in children with inverted dilacerated maxillary central incisors. The treatment plan involved arch expansion, surgical exposure using the closed-eruption technique, and orthodontic traction, which resulted in the proper alignment of the teeth. Early orthodontic treatment improved the morphology of the dilacerated roots, with newly developed roots growing along the direction of the axis of the crown. Furthermore, early treatment reduced the probability of root exposure during tooth alignment, thereby decreasing the need for endodontic treatment, including apicoectomy. These findings indicate that early orthodontic treatment may be considered for inverted incisors with dilacerated roots owing to its ability to promote the morphologic development of the curved roots, enhance the preservation of the teeth, and restore oral function.