Laser surgical approach to impacted maxillary incisors: case series and brief review

Report Authors' clinical case series on impacted maxillary incisors treatment with laser technology. Incisors transposition and impaction are rare in dental practice. In literature, many techniques are proposed to arrange impacted incisor in the dental arch. The gold standard is represented by creation of eruptive space, sometimes followed by a surgical exposure and traction of the teeth with orthodontic force application. Aim. To report the Authors’ clinical experience on impacted maxillary incisors and to present a singular case-report in a young man who has been treated with a multidisciplinary approach which involves minimally invasive extraction of an impacted central maxillary incisor, immediate re-implantation, guided bone regeneration and orthodontic alignment. Method. Sixteen impacted teeth were scheduled for guided eruption. Results. Study population was composed by 9 patients undergoing orthodontic treatment for lack of eruption of one or more upper incisors. Two patients had a spontaneous eruption after orthodontic creation of the correct eruptive space. Ten maxillary incisors were surgically exposed: in 5 patients seven un-erupted incisor were exposed through an apically positioned flap technique and in other one a closed eruption technique was performed on central and lateral left maxillary incisors; one patient has been treated with minimally invasive extraction of the impacted tooth, alveolar ridge reconstruction, immediate re-implantation and orthodontic alignment. All the impacted teeth were correctly aligned at the end of therapy; Conclusion. The positioning of the incisors was obtained by creating the eruptive space and aligning the un-erupted teeth after exposure of these with different surgical methods. In all patients the treatment allowed the restoration of the aesthetics and function of the stomatognathic apparatus.