Orthodontic approach to dilacerated central incisor localized horizontally on the anterior nasal spine: a case report.

The purpose of this paper was to present a case of surgical exposure of a horizontally impacted permanent maxillary left central incisor followed by fixed orthodontic treatment to eruption in a 9-year-old boy with a 2-mm overjet and 2-mm overbite who had sustained a traumatic injury to his primary maxillary central incisors when he was 6-years-old. Panoramic, occlusal, and cepholometric radiographs showed the affected tooth's crown to be positioned horizontally, and a CT scan showed the impacted central incisor's crown to be located below the anterior nasal spine and its apex to be located parallel to the palatal plane. A treatment plan was devised that included surgically exposing the impacted teeth and applying extrusive forces in the direction of the occlusal plane to bring about eruption. After 22 months of treatment, the central incisor erupted into the oral cavity. The patient now possesses the confidence to smile and enhanced self-esteem.