Interventions for promoting the eruption of palatally displaced permanent canine teeth, without the need for surgical exposure, in children aged 9 to 14 years

Expert consensus on pediatric orthodontic therapies of malocclusions in children

Malocclusion, identified by the World Health Organization (WHO) as one of three major oral diseases, profoundly impacts the dental-maxillofacial functions, facial esthetics, and long-term development of ~260 million children in China. Beyond its physical manifestations, malocclusion also significantly influences the psycho-social well-being of these children. Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition, by mitigating the negative impact of abnormal environmental influences on the growth. Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development, ranging from fetal stages to the early permanent dentition phase. From an economic and societal standpoint, the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated, underlining its profound practical and social importance. This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children, emphasizing critical need for early treatment. It elaborates on corresponding core principles and fundamental approaches in early orthodontics, proposing comprehensive guidance for preventive and interceptive orthodontic treatment, serving as a reference for clinicians engaged in early orthodontic treatment.

Success rate, treatment duration, and pain perception in the management of palatally impacted canines using the K9 and Ballista spring: a randomized clinical trial

OBJECTIVES

To evaluate the success rate, treatment duration, and pain perceived during forced eruption of maxillary palatally impacted canines using the K9 and Ballista springs.

MATERIALS AND METHODS

Thirty unilateral palatal canine impactions of moderate and difficult category as determined by KPG index (score between 10 and 19) were enrolled. Group 1 comprised canine impactions managed with K9 springs, and Group 2 comprised Ballista springs. Block randomization and opaque sealed envelopes were used for allocation. The success rate and treatment duration (application of force to ligation of the impacted canine into the initial alignment archwire) were recorded. Pain perception was evaluated on a 10-point visual analogue scale (VAS) and modified McGill Pain Questionnaire. Chi-square test and Mann-Whitney U-test were used to compare the groups.

RESULTS

The success rate for eruption of palatally impacted canines was 100%. The average treatment duration was 296.13 ± 96.45 days and 311.93 ± 94.34 days, respectively for Group 1 and Group 2. VAS scale scores for pain were greater for Group 2 compared to Group1, and the differences were statistically significant at all time intervals except at T1. The frequency of none and mild pain was significantly greater at all time intervals in both groups.

CONCLUSIONS

The impacted canines of moderate and difficult category were erupted with a 100% success rate and similar treatment duration with both interventions. The pain scores of Ballista springs were greater after 24 hours of force application.