We read the article by Dr Wei et al (Wei YJ, Lin YC, Kuang SH, Yang SF, Lee SY, Lai YL. Esthetic periodontal surgery for impacted dilacerated maxillary central incisors. Am J Orthod Dentofacial Orthop 2012;142:546-51) about the treatment of impacted dilacerated maxillary central incisors with great interest. The authors showed that soft-tissue management with periodontal surgical strategies can achieve desirable esthetic results of inverted dilacerated crowns. As we know, the length of the tooth root is associated with the eventual service and life of the tooth. Although the esthetic results are satisfactory, the root of the dilacerated maxillary central incisor in patient 1 is so short that it creates concern.

Since a midline discrepancy had been noticed in patient 1, what is the second stage of the orthodontic treatment plan for the patient? Is it possible to complete the second stage of orthodontic treatment with the short-rooted maxillary central incisor? What about the long-term follow-up of the dilacerated maxillary central incisor in this patient after the first stage treatment?

The authors initiated the orthodontic traction of the dilacerated tooth at the beginning of root formation in patient 2. Although the root formation of the dilacerated maxillary central incisor continued during the orthodontic tooth movement, the roots of the lateral incisors were not well developed, as shown in Figure 11, B , on page 550. Could the early intervention and tooth movement of the anterior teeth be the reason? The root development of the maxillary lateral incisors in patient 2 should be followed.

Although surgical exposure followed by orthodontic traction is a widely accepted way to save a dilacerated maxillary central incisor, as mentioned in the article, the health of the other teeth should also be considered.