Saving A Million Dollar Tooth

Orthotrain
Jul 11, 2025
2 min read

Updated: Sep 12, 2025

Name - Nandani

Address - Baramati

Age : 15 years

Chief Complaint: Missing upper left permanent central incisor.

Advised OPG .

Positive finding in OPG

Started fixed orthodontics with upper jaw.

Patient was called to Pune for further investigations (CBCT) and

treatment.

Investigations

CBCT

Clinical findings: Impacted tooth 21.

Diagnostic objectives: Evaluation of Impacted tooth no. 21.

CBCT scan of Maxilla of FOV 11 X 5 was performed on Planmeca Romexis 3D Classic. Axial, coronal and sagittal sections of resolution 0.150mm (high definition) were obtained.

POSITIVE RADIOGRAPHIC FINDINGS:

Reconstructed panoramic view:

Teeth present: 11,12,13,14,15,16,17,18,22,23,24,25.26.27.28.

Over-retained tooth: 61.

Impacted tooth: 21

Region of Interest: 21 region

Well-formed crown with single well-formed root noted.
Impacted tooth present in semi-vertical position.
. Orientation of impacted tooth: crown close to Incisive canal and root apex close to apex of 23.
Crown of impacted tooth noted in clase contact with labial cortical plate, # 61 (apical and palatal 10 #61).
Cervical and middle third region of root of 21 noted in close contact with 22 (apical and labial to 22).
Apical third region of root of 21 noted in close contact with #23 (apical and labial to #23), anterior surface of maxilla, lateral wall of Nasal cavity and aterio-medial wall of maxillary sinus.
Crown of 21 is positioned close to labial cortical plate. Anterior surface of maxilla.
No resorption of roots of adjacent teeth.
Thickness of labial cortex covering the crown and cervical region of root of 21 is approximately 0.5mm
Total length of impacted tooth 21 is approximately 21.80mm
Tip of impacted 21 noted in close contact with Incisive canal
Well-defined radiolucency noted around the crown of impacted tooth suggestive of enlarged follicular space.