title: Severe crowding and a dilacerated maxillary central incisor in an adolescent.
abstract: This study reports the treatment of an adolescent patient with dilacerated maxillary incisor. She complained of severe crowding with a high-positioned left upper canine. Her left central incisor had been impacted and moved to proper position at the age of eight years, resulting in a severe root dilaceration. To avoid any progression of root dilacerations and resorption in the maxillary incisor, maxillary lateral expansion and molar distalization plus multibracket appliance were selected as the best nonextraction treatment plan. The maxillary expansion and molar distalization should provide adequate space for the correction of the severe crowding, and treatment with a multibracket appliance was initiated. After a 17-month treatment with a multibracket appliance, an acceptable occlusion was achieved with a Class I molar relationship. An acceptable occlusion was maintained without recurrence of the crowding and impairment of the dilacerated root in the maxillary incisor during three years of retention. It is emphasized that careful planning is required to avoid any progression of the root dilaceration and resorption through orthodontic treatment. A shortening of the period of applying orthodontic force on the dilacerated incisor and avoidance of tooth extraction will minimize the risk factors.
authors.affiliation: Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan. etanaka@hiroshima-u.ac.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.forename: Takuro
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Hanaoka
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoneno
authors.forename: Eka
authors.initials: E
authors.lastname: Matsumoto
authors.forename: Diego
authors.initials: D
authors.lastname: Dalla-Bona
authors.forename: Eizo
authors.initials: E
authors.lastname: Yamano
authors.forename: Yohei
authors.initials: Y
authors.lastname: Suekawa
authors.forename: Mineo
authors.initials: M
authors.lastname: Watanabe
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanne
mesh_terms: D000293:Adolescent; D002508:Cephalometry; D002648:Child; D003481:Cuspid / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000002:abnormalities*; D008310:Malocclusion / Q000628:therapy*; D008312:Malocclusion, Angle Class II / Q000628:therapy; D008437:Maxilla; D008963:Molar / Q000473:pathology; D016910:Orthodontic Brackets; D018704:Orthodontic Retainers; D010155:Palatal Expansion Technique; D014087:Tooth Movement Techniques / Q000379:methods; D014092:Tooth Root / Q000002:abnormalities*; D014095:Tooth, Impacted / Q000628:therapy; D016896:Treatment Outcome