Periodontal considerations in the treatment of dilacerated maxillary incisors.

The treatment of a dilacerated maxillary incisor requires a multidisciplinary approach. Orthodontic, endodontic, and periodontal considerations are essential for successful treatment. A case that demonstrates the periodontal aspects of the treatment of this anomaly is presented. Treatment included (1) a conservative surgical technique for crown exposure that preserved a wide band of keratinized gingiva; (2) initial periodontal preparation before active orthodontic movement as well as a supplemental intensive maintenance program that continued throughout orthodontic treatment; and (3) a vestibular extension procedure designed to alleviate the shallow vestibular depth that can result in poor oral hygiene. Careful monitoring is essential to the long-term success of treatment.