Treatment of Dilacerated Incisors in Early and Late Stages of Root Development.

All patients in this study were referred to the Hospital of Stomatology, Fujian Medical University, Fujian, China, for orthodontic consultation between 2004 and 2014. Nolla’s method was utilized to determine each patient’s dental age.15,16 A tooth with only one-third (stage 7) or two-thirds (stage 8) of its root formation was assigned to the early dental-age group; a tooth with an almost complete root but an open apex (stage 9), or with a complete apical end (stage 10), was assigned to the late dental-age group. Orthodontic traction was successful in extruding 12 of the 13 early-stage DIs in our sample, with no need for root-canal therapy or apicectomy. On the other hand, eight of the 15 DIs in the late group had to be extracted due to crowding or severe crown-root angulations. A a dilacerated incisor (DI) is rarely encountered, such an anomaly makes it particularly demanding to restore facial esthetics. Treatment requires a well-synchronized, multidisciplinary approach.1 Among all the modalities targeting impacted and dilacerated upper incisors—including extraction followed by space closure or a fixed bridge,2 surgical repositioning,3 autotransplantation,4,5 apicectomy with root-canal therapy,6,7 and surgical exposure followed by orthodontic traction8-13—the last is the most widely used. Because labially impacted upper central incisors still have some potential for further root development,14 however, early orthodontic intervention is advisable. This article compares the results of orthodontic traction in a series of patients presenting with DIs in the early and later stages of dental root formation.