Orthodontic Eruption of an Odontoma-Impacted Maxillary Central Incisor: Clinical Case and Comprehensive Literature Review
Abstract:
Background: Impaction of a maxillary central incisor is an uncommon but clinically significant malocclusion that can affect aesthetics, function, and psychosocial well-being. Odontomas are the most frequent pathological cause of anterior tooth impaction. Management typically requires a multidisciplinary approach combining surgical and orthodontic interventions for successful eruption and long-term stability.
Case Presentation: This report describes a 13-year-old patient presenting with the absence of the maxillary left central incisor (tooth 21) and anterior crowding. Radiographic evaluation revealed impaction of tooth 21 due to a compound odontoma obstructing the eruption pathway. Treatment involved surgical removal of the odontoma, bonding of an orthodontic button to the impacted incisor, and gradual orthodontic traction using fixed appliances. Over a 48-month treatment period, tooth 21 was successfully guided into the dental arch, achieving proper alignment, functional occlusion, and satisfactory aesthetics without complications.
Conclusion: Successful management of odontoma-associated maxillary central incisor impaction relies on early diagnosis, space creation, surgical exposure, and controlled orthodontic traction. This case highlights the importance of a stepwise multidisciplinary approach in restoring function and aesthetics in anterior tooth impaction.
