Abstract
In clinical pedodontics, it is necessary to implement early treatment as the impacted teeth impede the growth of the dentition and the bite relationship. An appropriate diagnosis is however necessary. It is difficult to pronounce exact diagnosis of an inverse impacted maxillary central incisors based on X-ray examination.
We report on the three-dimensional images of the an inverse impacted maxillary central incisor using 3 DX Multi-Image Micro CT (3 DXTM, Morita Co., Japan) images for diagnosis, and we were able to begin marsupialization and traction at once.
The patient was a 7-year-old girl. The chief complaint of patient and her guardian was delayed eruption of the maxillary central incisors, with the need for aesthetic improvement. General factors and local factors which could cause an inverse impacted maxillary central incisor were not evident based on previous medical history.
First of all, the mesial side of the maxillary left central incisors and the midline were made to match by using a lingual arch. Three months after the beginning of treatment, we began marsupialization and traction at the same time. Also, it was possible to touch the edge of the impacted right central incisors, and in five months, the eruption of crown 2/3 was noted. Nine months after the beginning of traction, we were able to complete to induction of the impacted right central incisor for the inside of the dentition, and shortly after that the frontal teeth were disposed. Treatment was completed in 18 months. In the meantime, diagnosis was carried out using the 3 DXTM. The patient is now using a Hawley retainer.
For the future, the necessity of regular long term monitoring using 3 DXTM images is suggested to observe absorption of dental root and changes in the periodontium
