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Cornejo-Paz RH, Rodríguez-Cárdenas YA, Ruíz-Mora GA, Aliaga-Del Castillo A, Arriola-Guillén LE. Association of mandibular canine impaction and anatomical factors: A multicentre retrospective panoramic study in Latin America. Int Orthod 2024; 22:100867. [PMID: 38457898 DOI: 10.1016/j.ortho.2024.100867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. MATERIAL AND METHODS This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). RESULTS The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (β=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (β=0.97, P=0.001) and the probability of transmigration increased (β=1.05, P<0.001). CONCLUSIONS One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.
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Affiliation(s)
- Roger Homero Cornejo-Paz
- Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | | | | | - Aron Aliaga-Del Castillo
- Graduate Orthodontic Clinic, University of Michigan, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, Michigan, USA
| | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru.
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Germanò F, Guarnieri R, Mezio M, Barbato E, Cassetta M. The Use of CAD/CAM Technology in Mandibular Canine Disimpaction: A Case Report. Dent J (Basel) 2024; 12:79. [PMID: 38534303 DOI: 10.3390/dj12030079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
This case report of an 11-year-old subject shows the digital workflow for the management of an impacted mandibular canine using Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) technology along with Temporary Anchorage Devices (TADs). The miniscrew insertion site was planned using software, and a surgical guide was digitally designed and 3D printed. Orthodontic traction was performed using a 3D-designed and -printed device. In a single sitting, the miniscrew was inserted and the disimpaction device was also delivered. The primary objective of recovery and the repositioning of the impacted mandibular canine in the axis with its eruptive path was achieved. The space available and the subject's early stage of mixed dentition was considered favourable to a spontaneous eruption. This case report shows how CAD/CAM digital technology, combined with 3D printing, enables the creation of a surgical guide to position the miniscrew and the customized devices used for mandibular canine disimpaction. CAD/CAM surgical guides can help clinicians to position TADs with more accuracy and predictability, ensuring high quality bone support offering primary stability. Although orthodontic traction is the most complex therapeutic choice to implement, with the aid of CAD/CAM technology it is possible to proceed with accurate and minimally invasive orthodontic traction in order to recover a mandibular canine.
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Affiliation(s)
- Francesca Germanò
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Rosanna Guarnieri
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Martina Mezio
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Ersilia Barbato
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Michele Cassetta
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, 00161 Rome, Italy
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Wang Y, Chen X, Zhou D, Zheng L, Li X, Peng Y. Appropriate timing of treatment contributes to better root development of impacted anterior teeth in children. Am J Orthod Dentofacial Orthop 2024; 165:18-26. [PMID: 37656074 DOI: 10.1016/j.ajodo.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION This study investigated the effects of different timings of orthodontic treatment on the root development of impacted anterior teeth in children. METHODS The cone-beam computed tomography (CBCT) data of 45 children with impacted anterior teeth were divided into unformed root (UR) group or basically formed root (BFR) group to evaluate root length (RL) and root growth length (RGL) of impacted teeth and contralateral nonimpacted teeth pretreatment and posttreatment. In addition, 22 patients with impacted dilaceration were selected to assess the effects of the crown-root angle and root development stage on RL and RGL. The Student t test, Wilcoxon test, analysis of variance, and multiple linear regression analysis were used for statistical evaluations. RESULTS The RL of treated impacted teeth pretreatment and posttreatment was significantly shorter than contralateral nonimpacted teeth values (P <0.05). Posttreatment, the RL and RGL of impacted teeth of the UR group were significantly greater than those of the BFR group (P <0.05). The RGL of the dilacerated root in the UR group was considerably higher than in the BFR group (P <0.05). The larger crown-root angle group had a longer posttreatment RL (P <0.05). Multiple linear regression analysis revealed that the Nolla stage of impacted teeth and RL of contralateral teeth pretreatment significantly influenced the RL of impacted teeth posttreatment. CONCLUSIONS Prompt orthodontic treatment is necessary for children with impacted anterior teeth to release the impacted state and achieve better root development. The root length of a dilacerated tooth continued to develop under treatment, but the crown-root angle partly constrained it.
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Affiliation(s)
- Yi Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqian Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Center of Stomatology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
| | - Dan Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Liwei Zheng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaobing Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yiran Peng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Sathyanarayana HP, Nucci L, d'Apuzzo F, Perillo L, Padmanabhan S, Grassia V. Prevalence, etiology, clinical features and management associated with impacted and transmigrated mandibular canines: a systematic review. BMC Oral Health 2023; 23:975. [PMID: 38062382 PMCID: PMC10701972 DOI: 10.1186/s12903-023-03717-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The associated etiological factors and the clinical guidelines for the management are still not clear. The aim of this systematic review was to summarize the available data to report the prevalence and identify the etiological factors, clinical features, and various treatment outcomes in patients with mandibular canine impaction and/or transmigration. METHODS The review protocol was registered in PROSPERO (CRD42021222566) and was conducted and reported according to the PRISMA and Cochrane Handbook / Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A computerized search of studies published up to April 30, 2023, was conducted using the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature. A manual search of the reference and citation lists of eligible articles and existing systematic reviews for any additions were also conducted. The Newcastle-Ottawa Scale quality assessment tool was used to assess the studies' quality. RESULTS After removing 6 duplicates, 3700 articles were identified. For the final analysis, 19 studies published between 1985 and 2023 met all the eligibility criteria and were included. A total of 7 studies presented as good and 12 studies presented as satisfactory. Patients were screened in ten studies and diagnostic records from archives were retrieved in nine studies. The total number of diagnostic records screened was 138.394, and the total number of patients from the included studies was 43.127. CONCLUSIONS Based on the findings from this systematic review, the prevalence of mandibular canine impaction ranged from 0.008% to 1.29% while canine transmigration from 0.12% to 0.98%. Crowding of the mandibular arch, the presence of a retained deciduous canine, and odontoma or cyst are the etiological factors more commonly associated with mandibular canine impaction and or transmigration. Surgical extraction and surgical exposure followed by orthodontic traction are the two most frequently carried out treatment modalities in the management of mandibular canine impaction and or transmigration.
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Affiliation(s)
- Haritha Pottipalli Sathyanarayana
- Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (SRIHER), No 1, Sri Ramachandra Nagar, Chennai, Tamilnadu, 600116, India
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, via Luigi De Crecchio 6, Naples, 80138, Italy
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, via Luigi De Crecchio 6, Naples, 80138, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, via Luigi De Crecchio 6, Naples, 80138, Italy
| | - Sridevi Padmanabhan
- Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College & Hospital, Sri Ramachandra Institute of Higher Education and Research (SRIHER), No 1, Sri Ramachandra Nagar, Chennai, Tamilnadu, 600116, India.
| | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, via Luigi De Crecchio 6, Naples, 80138, Italy
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Ciavarella D, Maci M, Fanelli C, Lorusso M, Laurenziello M, Lo Muzio L, Caroprese M, Cazzolla AP, Tepedino M. Treatment of Mandibular Impacted Canine in a Patient with Class II Division 1 Malocclusion with "Reverse Pin": A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1774. [PMID: 37893493 PMCID: PMC10608428 DOI: 10.3390/medicina59101774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023]
Abstract
This case report presents an orthodontic treatment conducted on a 13-year-old girl with bilateral Class II malocclusion and a mandibular impacted canine. The presence of an impacted tooth necessitates careful consideration of the timing of orthodontic treatment, the appropriate surgical procedure to expose the tooth, the specific orthodontic mechanics involved, and the potential problems that may arise, all of which depend on the type and location of the canine impaction in the jaw. The treatment plan included a surgical procedure to expose the impacted tooth and orthodontic traction to guide it into position. Correction of the Class II Division 1 malocclusion utilized a specialized technique called the "reverse pin", reducing vertical side effects. The revised version maintains clarity and key information about the case report and treatment.
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Affiliation(s)
- Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Marta Maci
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Carlotta Fanelli
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Mauro Lorusso
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Michele Laurenziello
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Marino Caroprese
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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Stabryła J, Zadurska M, Plakwicz P, Kukuła KT, Czochrowska EM. Comparisons of Dental Anomalies in Orthodontic Patients with Impacted Maxillary and Mandibular Canines. Diagnostics (Basel) 2023; 13:2766. [PMID: 37685304 PMCID: PMC10487134 DOI: 10.3390/diagnostics13172766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
To assess the presence and possible associations between the type of dental anomalies and maxillary and mandibular canine impactions in orthodontic patients treated for canine impaction, panoramic radiographs of orthodontic patients treated for canine impaction were assessed for the presence of associated dental anomalies. A random sample of orthodontic patients without canine impaction matched for age and gender served as controls. Descriptive and exact inferential statistics were implemented in order to assess potential associations between canine impaction and dental anomalies. A total of 102 orthodontic patients with 70 maxillary (MaxCI) and 32 mandibular (ManCI) canine impactions were assessed. The control group included 117 orthodontic patients. Dental anomalies were present in more than 50% of patients with impacted canines and in 20% of the controls. Tooth agenesis was significantly more common in the MaxCI group when compared to the ManCI group, while supernumerary teeth and canine transmigration were registered more often in the ManCI group. When compared to the control group, peg-shaped maxillary lateral incisors and tooth agenesis were significantly more prevalent in the MaxCI group, while canine transmigration, supernumerary teeth, the agenesis of mandibular incisors and tooth transpositions were significantly more prevalent in the ManCI group. The impaction of other teeth was significantly more common in both canine impaction groups when compared to the controls. The prevalence of dental anomalies in orthodontic patients with impacted canines was higher than in orthodontic patients without canine impaction. Different types of tooth anomalies were found in the MaxCI and ManCI groups.
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Affiliation(s)
- Joanna Stabryła
- University Medical Center, Medical University in Warsaw, 02-097 Warsaw, Poland;
| | - Małgorzata Zadurska
- Department of Orthodontics, Medical University in Warsaw, 02-097 Warsaw, Poland;
| | - Paweł Plakwicz
- Department of Periodontology, Medical University in Warsaw, 02-097 Warsaw, Poland;
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Bocchino T, Perrotta S, Martina S, D’Antò V, Valletta R. “Canine First Technique”, An Innovative Approach in Maxillary Impacted Canines: A Case Report. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2209140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background:
Maxillary canine impaction is one of the most challenging issues in orthodontics. The best treatment protocol in these cases is still debated. The purpose of this study is to describe the management of maxillary canine impaction in an adult female patient with the “Canine First Technique”.
Case Report:
A 21-years-old female attended our dental unit seeking orthodontic treatment. Clinical examination revealed a class II relationship, the persistence of both upper deciduous canines. The panoramic X-ray and Cone Beam Computed Tomography showed bilateral palatal permanent canine displacements and close proximity between crowns of impacted canines and roots of lateral incisors. The canines were disimpacted by means of two cantilevers inserted directly in two Temporary Anchorage Devices placed palatally and when canines were near the crest, the fixed orthodontic treatment was started.
Results:
At the end of the treatment, canine Class I relationships with torque correction of canines, normal overjet and overbite, and good alignment of dental arches were achieved. The radiographic evaluation showed ideal root parallelism and preserved periodontal health in the canine region.
Conclusion:
The Canine First Technique could provide some advantages compared to conventional approaches in terms of biomechanics, esthetics, oral hygiene, and risk reduction of root resorption of upper lateral incisors.
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