Orthodontic intervention of an impacted upper left central incisor due to odontoma. A case report

Abstract

Aim: To present a case of a compound odontoma impeding eruption of the permanent upper left central incisor and to narrate its management. Case history: A 12-year-old girl attended at Muhimbili National Hospital dental clinic complaining of a missing upper anterior tooth. At the age of 3 years the patient sustained injury on the anterior part of the upper jaw. A decidous tooth was fractured and eventually extracted. Oral tissues were healthy and the dentition was caries free. Molar relationship on the right-half a unit was class II, on the left full unit class II. Moderate crowding was observed on the upper right and lower right arches, whereas, mild crowding was seen on the lower left arch. No detrimental para functional habits were noted. Radiographic examination revealed the presence of a radiopaque mass with features consistent with an Odontoma, it was overlying an impacted upper left central incisor and had a size of about 4 X 4 mm. Treatment done: The odontoma was surgically removed. A fixed orthodontic appliance was used to facilitate traction and correction of malalignement of the impacted upper left central incisor.Treatment outcome: Successful removal of the odontoma, full exposure of the crown of upper left central incisor and good alignment on the arch were achieved. Crowding on the upper and lower arches was relieved and leveling of both arches together with improvement of midline shift resulted in good facial aesthetics. Conclusion: Successful removal of the impeding odontoma followed by orthodontic management of an impacted incisor with a fixed appliance successfully restored the child’s aesthetics and self esteem.