Innovative treatment strategies for impacted maxillary central incisor and case comparisons

BACKGROUND: The present article compares innovative treatment strategies for impacted maxillary central incisors, emphasizing the critical importance of prioritizing root development over rapid crown alignment. METHODS: Two case reports using distinct clinical approaches are presented. Case 1 utilized a traditional combination of closed-eruption surgical exposure and conventional orthodontic traction, while Case 2 utilized a novel root-oriented traction technique, which ensures the development of tooth roots and utilizes the natural eruption power. RESULTS: Both techniques achieved successful eruption and alignment. However, the root-oriented method demonstrated superior outcomes in promoting continued root formation, manifested as a larger volume and surface area of tooth roots, reducing the risk of premature apical closure. CONCLUSION: The primary objective in managing an impacted maxillary central incisor should be to reduce root developmental resistance and ensure substantial root development, rather than to achieve rapid crown alignment.