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The roots of many impacted incisors and first molars have a hooked apex, which is usually blamed as the cause of the impaction. But is it really the cause? Perhaps the tooth is prevented from eruption by a different cause and the apical area then becomes hooked due to an anatomic barrier, such as the maxillary sinus, the lower border of the mandible, the floor of the nose, the infra-alveolar nerve bundle, or due to pathologic barrier, such as invasive cervical root resorption and pre-eruption intra-coronal resorption. Appropriate treatment of the cause may permit spontaneous or orthodontic-driven eruption to occur, regardless of a hooked root apex.
