역위 매복된 상악 중절치의 외과적 재위치 후 치근 발육 정지

Abstract

Impaction of the maxillary central incisor may cause social, esthetic, and functional problems in children. There are various means of treatment for the inverted maxillary central incisor, such as extraction, surgical opening followed by orthodontic traction surgical repositioning or intra-alveolar autotransplantation prior to extraction. In this case, we surgically repositioned the inverted maxillary central incisor to normal semi-erupted position in a 5-year-old boy The developmental stage of the inverted tooth was Nolla's 6.5, which indicates formation of less than one third of the root. After surgical reposition, we did follow-up for 21 months, expecting spontaneous growth Unfortunately, poor prognosis was noted further root was not observed. Such failure seems to originate from possible injury on Hertwig's epithelial root sheath by surgical trauma. We performed surgical repositioning to retain the tooth instead of extraction. However, arrest of root development occurred which is one of the critical complications. In order to increase the success rate of the surgical reposition procedure, minimal surgical trauma is required as well as selection of adequate indication and decision of proper time of treatment considering the stage of root development.