SURGICAL EXPOSURE OF AN IMPACTED MAXILLARY CENTRAL INCISOR AND RECONSTRUCTION OF A BAND OF KERATINIZED GINGIVA -A CASE REPORT.

Delayed and ectopic eruption of a permanent tooth is a significant concern and needs an interdisciplinary management. Ectopic eruption of permanent teeth restricts or eliminates the keratinized tissue between the erupting cusp and the deciduous tooth and as a result, labially or buccally erupting teeth show reduced dimensions of the keratinized gingiva. Lack of attached gingiva imposes potential risk for gingival recession in labially or buccally erupted teeth due to the possibility of accumulation of plaque and/or traumatic tooth-brushing during subsequent orthodontic treatment. A good interdisciplinary team-work is needed between the orthodontist and periodontist for guiding the ectopic tooth into its proper position within the dental arch with an adequate band of keratinized gingiva surrounding the tooth. This paper discusses the validity of utilizing pedicle split-thickness flap surgery to increase a band of keratinized tissue in a case of an impacted maxillary central incisor erupting from the alveolar mucosa.