Root dilaceration

Last revised by Henry Knipe on 23 Jan 2023

Root dilaceration is a dental deformity presenting as an acute angulation, deviation or curvature of the crown-root axis.

Possible causes include:

  • trauma during root development

  • adjacent dentigerous cyst or tumor can lead to an abnormal angle in a developing tooth

  • hereditary factors may be involved in a small number of cases

Root dilaceration can present in both the permanent and deciduous dentition. It most commonly occurs in the posterior teeth and maxilla.

On orthopantomography (OPG) if the dilaceration of the root happens to occur either in the buccal or lingual direction, then the deflection from the root could give an appearance of bull’s eye (the apical foramen presenting as an eye and surrounding the periodontal ligament space as radiolucent halo).

The radiograph is a two-dimensional image and the bony ligament surrounding the affected tooth appears grayish because of the increased density of the x-ray beams at the area of the dilaceration.

Cone-beam CT is more accurate with benefits of less radiation exposure, better contrast and higher resolution of the tooth examined.

Evaluating factors as the severity of the dilaceration, its location, the amount of root formed and the amount of space around the impacted tooth, a decision is made whether to reposition the tooth or remove it altogether:

  • orthodontic traction when the tooth can be repositioned in the dental arch

  • extraction with treatment to close the space created following the removal of the dilacerated tooth

  • crown of the tooth may stay unerupted or might erupt ectopically

  • inflammatory bulge in the soft tissues

A dilacerated root, first reported in 1848, has been called a sickle, a scorpion and also the "hand of a traffic policeman" previously.

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