Author: Dr Shaun Goh
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Treatment Indications & Timings
Clinical Assessment & Presentations
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Description
Ectopic incisor
“An ectopic permanent incisor is an incisor which has deviated from its normal path of eruption. It may present as an erupted or unerupted tooth.”
– Cobourne and DiBiase 2010
Unerupted ectopic incisors
A unilateral unerupted upper incisor requires an investigation for a possible ectopic incisor.
Erupted ectopic incisors
Ectopic lower incisors due to retained primary incisors and a lingually-positioned developing permanent tooth bud.
Upper and lower incisors can be ectopic. These teeth may be unerupted or erupted as seen on the above images. The most commonly affected incisors are the upper central incisors. These incisors tend to erupt around the age of 6 to 7 years old. Delayed or asymmetric eruption signs should be investigated for common causes of ectopic incisors such as obstructions or root development abnormalities.
Treatment Indications & Timings
Treatment indications:
*The optimal time to treat or refer ectopic incisors is between 6 to 8 years old when delayed or asymmetric eruption has been noted.
➤ Delayed eruption of incisors
➤ Obstruction of the incisor eruption or alignment
➤ Abnormal root development of the incisors
➤ Pathology or abnormalities associated with the incisors
Clinical Assessment & Presentations
Radiographic Features
Obstruction of incisor eruption
Abnormal root development
Pathology associated with incisors
Diagnosis & Considerations
Diagnosis
- Developmental causes
- Genetic causes
- Environmental causes
Clinical Considerations
- Spontaneous eruption or active traction after removal of obstruction?
- Accommodation of abnormal root development
Treatment Options
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➤ Alignment of an ectopic erupted incisor
➤ Retrieval of an ectopic unerupted incisor
➤ Removal of an ectopic incisor
Associated Problems
Spacing | Supernumerary teeth