What age should the permanent central incisors emerge?
7 years old
What is a method to speed up the eruption of permanent successors?
Extraction of correspodning deciduous tooth (±adjacent teeth)
Illustrate a way to chart the early mixed dentition
Which region of the oral cavity would you check for the missing central incisor?
Upper labial sulcus
What are the possible causes of an apparently absent upper central incisor?
- Missing
- Developmentally absent
- Extracted
- Avulsed
- Failure to erupt
- Dilaceration and/or displacement as a result of trauma
- Scar tissue preventing eruption
- Supernumerary tooth preventing eruption
- Insufficient space as a result of crowding
- Pathological lesion
- Cyst
- Odontogenic tumor
What specific question would you ask to the parent of the patient with missing incisor?
- Trauma-related question (avulsion or dilaceration)
- Deciduous predecessor discolored?
- Loss of vitality
- Previous injury to face/lip/teeth
What can cause a shift in the centre line?
- Crowding
- Early exfoliation of the canines
What is dilaceration?
- An angulation, or a sharp bend or curve, in the root or crown of a formed tooth
- Caused by intrusion
Can crowding cause delay in eruption of permanent successor?
- Yes, but it would not delay eruption uf up to 2 years
What radiographs would be taken in this instance?
- Dental panoramic radiograph
- General view
- Presence/absence of permanent teeth
- Supernumeraries (?)
- Periapical radiographs
- Root morphology
- Adjacent structures
- Supernumerary teeth
- Pathological lesions
- PA view should include adjacent teeth
- SLOB rule
- Lateral view
- Distrotion of tooth
What action would need to be taken if dilaceration was severe?
- Extraction of dilacerated tooth
- Immediate replacement of incisor by dentureadhesive bridge with permanent restoration or single tooth implant
What pre-conditions need to be met for orthodontic realignment (extrusive traction)?
- Dilaceration of tooth not too severe
- Dilaceration lies in apical portion of the root
What factors need to be considered in the selection of a particular treatment?
- Position and seveirty of dilaceration
- Size of overjet
- Degree of crowding
- Position and condition of the other permanent teeth
- General condition of the mouth
- Attitude of the child and parent
