Treatment algorithms of patients with impaction of maxillary central incisors caused by supernumerary teeth

Abstract

Introduction: Supernumerary teeth, like etiological factor of impaction, occur in 7,05% of patients, are usually located in anterior maxillary region – 93,2%. Aim of the study: The aim of the study is to develop an algorithm of treatment of patients with impaction of permanent maxillary central incisors, caused by supernumerary teeth, during periods of mixed and permanent dentition by processing our own approaches to treatment. Materials and methods: Treatment results of seven patients (6, 7 (2 patients), 8, 9, 10 and 15 years old) with delay in eruption of maxillary central incisors were analyzed. According to the results of clinical and additional examination methods (photometric examination of face, study of diagnostic models of jaws and orthopantomograms, 3D computed tomography), impacted central incisors, supernumerary teeth, blocking their eruption, were diagnosed. Results: Clinical experience of treatment of patients with impacted teeth caused by presence of supernumerary teeth in the jaws, allowed us to propose algorithms of providing complex treatment in such cases, depending on physiological state of occlusion - mixed or permanent, and depth of supernumerary tooth location. Conclusions: If there are no central incisors in the dental arch after the term of their physiological eruption, orthopantomogram must be taken to confirms or reject tooth impaction, and then 3D computed tomography should be done to show accurate localization of the tooth and only after these stages it is possible to choose the treatment plan. Patients with impacted maxillary central incisors caused by supernumerary teeth should undergo orthodontic treatment in several stages.