Management of Unerupted

Maxillary Incisors
Omar Yaqoob Catherine Bryant
BDS MFDSRCS MSc MOrthRCS BDS FDSRCS MSc
FDSRCSEd FHEA Consultant in Oral Surgery
Specialist Orthodontist Department of Oral Surgery
Specialist Practice King's College Hospital Dental Institute
Denmark Hill, London SE5 9RW
Julian O’Neill
BDS MSc FFDRCSI MOrthRCS Joe Noar
Consultant Orthodontist MSc BDS FDSRCS(Ed) FDSRCS(Eng)
Maxillofacial Unit DOrthRCS(Eng) MOrthRCS(Eng) FHEA
Kettering General Hospital Consultant/Hon. Senior Lecturer
Northants NN16 8UZ Orthodontic Unit
Division of Craniofacial & Development
Shruti Patel Sciences
BDS FDSRCS MSc MOrthRCS Eastman Dental Hospital/Institute
FDSOrthRCS 256 Gray's Inn Road
Consultant in Orthodontics London WC1X 8LD
King’s College Hospital NHS Trust
London SE5 9RS Terry Gregg
FDSRCPS, FDSRCS, FFDRCSI
Jadbinder Seehra Consultant in Paediatric Dentistry
BDS(Hons) MFDSRCS MSc MOrthRCS Barts Health Dental Hospital
FDSOrthRCS Turner Street
Consultant Orthodontist and Hon Clinical London E12AD
Senior Lecturer, Department of Orthodontics
King's College London Dental Institute
London SE1 9RT, UK
David Morris
BDS FDSRCS FDSOrthRCPS MSc
MOrthRCS
Consultant in Orthodontics
Department of Orthodontics
Leeds Dental Institute
Leeds, LS2 9LU, UK

Martyn T.Cobourne
FDSRCS, FDSOrthRCS, PhD
Professor and Hon Consultant in
Orthodontics
Department of Orthodontics
King's College London Dental Institute
LONDON SE1 9RT
Management of Unerupted Maxillary Incisors

Contents
Introduction.............................................................................................................................................................................. 1
1 Diagnosis and management ......................................................................................................................................... 1
1.1 Definition ............................................................................................................................................ 1
1.2 Causes of delayed eruption ............................................................................................................... 1
2 Incidence and prevalence ............................................................................................................................................. 1
3 Establishing the cause of eruption failure ................................................................................................................. 1
3.1 Medical and dental history ................................................................................................................. 1
3.2 Clinical examination ........................................................................................................................... 2
3.3 Radiographic examination ................................................................................................................. 2
4 General principles of management ............................................................................................................................ 2
4.1 Patient factors .................................................................................................................................... 2
4.2 Dental factors ..................................................................................................................................... 3
5 Management options ..................................................................................................................................................... 4
5.1 Removal of a physical obstruction ..................................................................................................... 4
5.2 Removal of the obstruction only ........................................................................................................ 4
5.3 Surgical intervention(s) ...................................................................................................................... 4
5.4 Incisor removal .................................................................................................................................. 6
5.5 Ankylosed maxillary incisors .............................................................................................................. 6
5.6 Autotransplantation ............................................................................................................................ 6
5.7 Monitoring of further dental development .......................................................................................... 6
Recommendations .................................................................................................................................................................. 6
References ................................................................................................................................................................................ 7

i
Management of Unerupted Maxillary Incisors

Introduction

2 Incidence and prevalence

1 Diagnosis and management

 ½

1.2 Causes of delayed eruption

1
Management of Unerupted Maxillary Incisors

3.2 Clinical examination

4 General principles of management

3.3 Radiographic examination

4.1 Patient factors

2
Management of Unerupted Maxillary Incisors

4.1.2 Age 4.2.3 Developmental stage of the impacted

4.2.4 Nature of any physical obstruction to

4.2 Dental factors

4.2.2 Position of the impacted incisor

4.2.5 Unfavourable root formation

3
Management of Unerupted Maxillary Incisors

5.2.1 Removal of the obstruction with creation

5 Management options
5.1 Removal of a physical obstruction

5.3 Surgical intervention(s)

5.2 Removal of the obstruction only

4
Management of Unerupted Maxillary Incisors

5.3.2 Closed eruption technique

5.3.1 Open exposure

5.3.3 Open versus closed eruption techniques

5
Management of Unerupted Maxillary Incisors

5.4 Incisor removal

5.6 Autotransplantation

5.7 Monitoring of further dental development

Recommendations

6
Management of Unerupted Maxillary Incisors

References

7
Management of Unerupted Maxillary Incisors

8
Management of Unerupted Maxillary Incisors