Pulpal exposure during closed surgical exposure of an unerupted maxillary incisor

Despite their relatively low incidence, unerupted maxillary incisors have a sizeable impact on a patient's function, phonetics and aesthetics. Management of these teeth commonly involves surgical exposure and orthodontic traction. This report describes a previously unreported intra-operative finding. During surgical exposure of an unerupted maxillary incisor, the pulpal tissue was found to be continuous with the oral mucosa. Subsequent separation of the tissues resulted in pulpal necrosis, requiring endodontic management. Awareness of unique complications is required. To ensure valid consent, all risks and alternative treatment options for these must be clearly communicated. CPD/Clinical Relevance: Despite meticulous planning, not all intra-operative complications can be anticipated, hence good patient communication is important.