Management of unerupted maxillary incisors

Abstract

SUMMARY AND RECOMMENDATIONS 1. Children up to nine years with incomplete root development of permanent incisor:> Remove obstruction.> Do not uncover bone from unerupted incisor – maintain integrity of follicle.> Create space if required.> Monitor eruption for 18 months – 80% erupt spontaneously> If exposure required then expose minimally to eliminate soft tissue obstruction. If tooth is still high, expose and bond bracket.> For best aesthetics: i. avoid excision of attached gingivae; and ii. avoid apically repositioned flaps.2. Children above nine years with complete or nearly complete apex:> Remove obstruction.> Create space if required.> If permanent incisor high then monitor eruption for 12 months.> If tooth still unerupted at 12 months, expose and bond bracket as required.3. If permanent incisor is impacted:> Expose and bond bracket at first operation.4. Children referred late (over 10 years):> Remove obstruction, expose and bond bracket at first operation.