PMC9441586_01
Radiographic Examination: (A) Periapical radiograph shows permanent central with immature roots and partially resorbed root of the primary left central incisor (#61). (B) Periapical radiograph taken at six-month recall shows permanent left central incisor (#21) with immature root. (C) Panoramic radiograph shows mixed dentition stage, localized disturbance of eruption as (#22) is more advanced than #21. Also, the permanent upper right canine (#23) is bypassing the midline of (#22).
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A periapical radiograph showed a permanent central incisor (#21) with an open apex and partially resorbed root of the tooth (#61) (Figure 1A). A periapical radiograph was taken for (#21), and the root was found to be immature (Figure 1B). In addition, the permanent upper left canine (#23) bypassed the midline of (#22), which was alarming for future canine impaction (Figure 1C).
Clinical Photographs: (A) Intra-oral photograph shows raised the buccal flap and exposed upper permanent central and lateral incisors. (B) Intra-oral photograph shows the apical repositioned flap sutured opposite to the tooth 21, 22 using 3/0 Vicryl absorbable suture materials. (C) Intraoral photograph acquired at one-month recall shows partially erupted and lingually positioned #21 and good eruption of #22.
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The strip of the fibrous keratinized gingival tissue was removed, and then the full buccal-mucoperiosteal flap of 3-4 mm was raised to expose the incisal edge of (#21) and (#22) (Figure 2A). Two interrupted sutures were also placed mesial and distal to the teeth (#21) and (#22) (Figure 2B). Also, the tooth (#22) erupted in a good position (Figure 2C).
(A) Intraoral photograph acquired at six-month recall shows good eruption of #21, self-correction of crossbite, with enamel hypoplasia of the cervical part of the crown. (B) Intraoral radiograph acquired at six-month recall shows improved position with the roots still open.
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Enamel hypoplasia of the cervical part of the crown was also seen (Figure 3A). The periapical radiograph showed that the root was still immature which indicates a chance for more eruption (Figure 3B).