A report of inverted primary maxillary central incisors

Abstract

INTRODUCTION: Tooth impaction in primary dentition is a rare phenomenon. Among the few reported cases, primary second molars are most frequently involved, followed by primary central incisors and first molars. Reported contributing factors include: mechanical obstruction in the path of eruption, like odontomes and ameloblastic fibroma, ectopic position of tooth germ due to trauma or other reasons, primary failure of eruption, ankylosis, infection and interferences of tooth development. CASE REPORT: A 5-year-old Chinese girl visited with a complaint of missing bilateral primary maxillary central incisors. Medical history was non-contributory, and there was no known history of intra-oral infection or trauma. Pregnancy and delivery were normal. Patient had finger-sucking habit since birth. There were callus and peeling on her fingers. Clinical examination identified moderate enlargement in the buccal aspect of the alveolus in the missing teeth 51 and 61 region with no pain in palpation. Teeth 72 and 82 were in crossbite. Radiographic examination revealed that teeth 51 and 61 were inverted with open apexes and incomplete root formation. The inverted teeth were near to the displaced permanent tooth germs of 11 and 21. The inverted teeth 51 and 61 were then surgically removed under general anaesthesia. The patient was regularly reviewed. Permanent teeth 11 and 21 in good condition erupted in a displaced position two years after. COMMENTS: Finger-sucking habit may be the contributing factor to the impaction. Primary teeth impaction could affect the eruption and development of their permanent successors. Early diagnosis and intervention are necessary.