UNUSUAL PRESENTATION OF ‘U-SHAPED’ IMPACTED MAXILLARY CENTRAL INCISOR WITH INTRANASAL ROOT SUCCESSFUL SURGICAL MANAGEMENT

Abstract

BACKGROUND: Dilacerations is a tooth deformity characterized by an angulation between crown androot causing non-eruption of the tooth. It generally occurs following trauma to the deciduous dentitionapices of which lie close to the permanent tooth buds. According to Neville, maxillary and mandibularincisors contribute only approximately to 1% of the incidence of dilacerated teeth.CASE DETAILS: A 15 year old male patient reported with chief complaint of missing anterior teeth inthe left side of maxillary arch. Radiographic evaluation showed impacted maxillary left central incisor.The radiograph depicted very unusual extreme curve in the root of the same tooth giving it characteristicU-morphology. The root of this tooth was curving into the nasal cavity. Due to extreme curve, surgicalremoval was suggested by orthodontist. Surgically removing this highly placed tooth with apex into nasalcavity was a surgical challenge. This was done effectively by removing the tooth under local anesthesiaitself.CONCLUSION: U-shaped morphology in single rooted tooth is observed very rarely. This root curvaturepredisposes to fracture of root during surgical removal. Proper surgical protocol is to be followed duringsurgical removal of a tooth with such extreme root curvature to prevent fracture of the root andaccidental displacement of the tooth into nasal cavity.