Orthodontic management of an impacted maxillary central incisor with a Talon cusp and dilacerated root: a case study

Abstract

The orthodontic management of an impacted maxillary central incisor with a talon cusp and dilacerated root in a 23-year-old female is reported. The patient presented complaining of an inability to smile because of the irregular arrangement of her front teeth. An oral examination revealed absence of the maxillary right central incisor with a prominent bulge high up in the labial sulcus just beneath the nasal floor. There was also space loss anteriorly with drifting of the adjacent lateral incisor mesially. Radiographic evaluations, which included a periapical, an upper occlusal and an orthopanthomogram revealed a mesio-angularly mesio-labially rotated impaction with a talon cusp on the palatal aspect, a dilacerated ‘c’ shaped root grooving the antral floor and straddling the root of the adjacent tooth. Orthodontic management repositioned and derotated this tooth resulting in an aesthetically favourable outcome. The results obtained in this case with a very poor prognosis demonstrate a successful aesthetic and functional tooth which is stable even one year post-operatively.

Keywords: orthodontic management, impacted tooth, dilacerated root