Dilaceration

Image taken from Clinical Guide to Oral Diseases.

I’m sure we’ve all encountered this type of tooth many times in clinical practice, but it never occurred to me that there was actually a specific term for it.

Dilaceration is the abrupt deviation of the long axis of the crown or root portion of the tooth (>90°) leading to a sharp bend or curve and this may be related to caused trauma during odontogenesis.

Which is/are the difference/s between dilacerations and flexions:

• In flexion the deviation is restricted on roots while in dilacerations on roots or crowns.
• In flexion the degree of root deviation is less than in dilacerations (< 90°).
• Both dental anomalies are mainly seen in permanent teeth with normal crown and have been possibly associated with history of previous trauma, altered germ position and delayed tooth eruption.

Possible causes of this dental anomaly:

• Local trauma to the primary predecessor tooth due to accident or iatrogenic procedures (laryngoscopy or endotracheal intubation) is the most­ common cause of the crown In the absence of trauma, dilaceration may be dilacerations of the succedaneum permanent teeth.
• Idiopathic it is based on the fact that there is low frequency of dilacerations contrary to the high frequency of local trauma among children. This idea is reinforced by the observation that trauma involves more than one tooth and dilacerations affect isolated teeth.
• Scars are formed easily after a local injury or infections affecting the development of­ permanent teeth, causing alterations in their morphology.
• Congenital lesions like hemangiomas or facial clefts and cysts or even tumors may cause ectopic development of permanent tooth germs and delay of primary tooth resorption that leads to longer retention of primary teeth and morphological anomalies of permanent teeth.
• Heritage seems to play a role as there are a number of dilacerations have been seen among twins or close relatives of certain races.