Introduction: Impaction of a permanent maxillary central incisor is a rare condition with a reported incidence of around 0.06 –0.2%, caused by several etiological factors that results in compromised esthetics and speech. Management includes surgical removal of any physical obstruction in the incisor eruption path, followed by either spontaneous tooth eruption or actively erupting it with an orthodontic appliance.
Case Description: This report describes the interceptive management of an impacted left maxillary central incisor (LMCI) in an eight-year-old girl with a history of an avulsion injury to its primary predecessor. Clinical assessment revealed an adequate space in the maxillary arch for the unerupted incisor and the radiographic assessment confirmed a labial impaction of the LMCI with a favorable position. The LMCI had an incomplete root and no obvious physical obstruction so was managed by surgical exposure and orthodontic traction.
Treatment results: The LMCI was adequately aligned with normal periodontal tissues and there were no adverse effects on the maxillary dentition.
Conclusion: Recovery of an impacted maxillary central incisor is crucial, as this tooth has an important role in facial esthetics and speech. The close collaboration of the orthodontist and the oral surgeon resulted in the successful recovery of the tooth. Cases of impacted maxillary incisors must be assessed individually, and the risks/benefits of treatment must be weighed carefully and clearly explained to parents/legal guardians before treatment.