Dilaceration

Dilaceration is the anamolie in the tooth shape and its structure and it refers to a sharp bend in the tooth which can be in the crown portion or in the root, making sharp angles at the junction of the crown and root. The abnormal Angulation may be present anywhere along the the length of tooth.

It is also described as “Dilaceration is the result of a developmental anomaly in which there has been an abrupt change in the axial inclination between the crown and the root of a tooth”

It occurs as a result of trauma to the predecessors of the permanent teeth, and it is seen that Dilaceration of the root is more common than that of crown.

Etiology: The cause of this anamoly in the shape of the tooth has two main reasons:

  • Trauma
  • Developmental disturbances
  • Developmental Syndromes
  • Trauma secondary to neonatal laryngoscopy and
  • Edotracheal Intubation

Injury displaces the calcified portion of the tooth germ, and the remainder of the tooth is formed at an abnormal angle. The damage mostly follows avulsion or intrusion of the overlying primary predecessor, and event that normally occurs before 4 years of age. Rarely the bend develops after the presence of an adjacent cyst, tumor or Odontogenic Hamartoma (ex: Odontoma, supernumerary teeth)

Clinical and Radiographic Features :

  • The most commonly involved teeth are the Permanent Maxillary Incisors followed by the mandibular anterior teeth. Occasionaly decidious teeth are also involved.
  • Dilaceration is seen in both Permanent and Decidiuos teeth.
  • Maxillary anterior teeth which exhibit dilaceration often lead to “Failure of Eruption”
  • Mandibular incisors which exhibit dilaceration often show full eruption unlike Maxillary anterior teeth. After eruption these teeth often show Labial or Lingual inclination.
  • Mandibular teeth with dilaceration are often Non Vital and exhibit a periapical inflammatory lesion.
Dilacerated tooth with curved roots radiograph

Dilacerated tooth with curved roots radiograph

Treatment and Prognosis:

  • Extraction of Primary deciduous teeth should be “Extracted” if they demonstrate undesired Resorption and result in delayed eruption.
  • Grossly deformed teeth require Surgical extraction because of extensive deformation of the affected tooth, repositioning and perforation of the buccal alveolar ridge by the mispositioned root.
  • In mild dilaceration cases, no treatment is required.

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