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Arriola-Guillén LE, Rodríguez-Cárdenas YA, Ruíz-Mora GA, Aliaga-Del Castillo A, Dias-Da Silveira HL, Dutra V. Effectiveness and side effects of orthodontic traction of impacted maxillary incisors in a labially inverted position: A systematic review. Int Orthod 2024; 22:100916. [PMID: 39181039 DOI: 10.1016/j.ortho.2024.100916] [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: 07/16/2024] [Revised: 08/07/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION Treatment of impacted upper incisors in a labially inverted position is challenging for orthodontists, and its prognosis has not been established in the literature. Thus, this systematic review aimed to determine the effectiveness and side effects of orthodontic traction of impacted maxillary incisors in a labially inverted position. METHODS A comprehensive search was conducted in multiple databases, including MEDLINE (via PubMed), Scopus, Embase, Science Direct, and LILACS, up to June 30, 2024. Initially, 1640 articles were identified, and after applying specific selection criteria, 11 articles were selected for full-text evaluation. Following the review, only six studies were deemed relevant, comprising one before-and-after study, two longitudinal retrospective studies, and three cross-sectional studies. Newcastle-Ottawa and Risk of Bias (ROB-2) tools were used to assess the risk of bias in the selected studies. RESULTS The average duration of traction for maxillary labially inverted impacted central incisors ranged from 8.60±1.26months to 18±6.0months, with all cases being successfully treated. Following traction, the clinical crown height of the incisors was significantly higher compared to the control group (P<0.01). Similarly, the root length of the impacted incisors after traction was shorter in the impaction group (approximately 2mm) compared to the control group. Likewise, the thickness of the alveolar bone varied among different studies. Some authors noted that the treatment group had a smaller thickness (about 0.5mm) compared to the control group (P<0.05), while other authors found similar thickness after treatment. CONCLUSIONS Although there are few reported studies with a low risk of bias, it is clear that it is possible to successfully treat labially inverted impacted maxillary central incisors with apparently few side effects. Following traction, the clinical crown height of these incisors increased, while the root length was shorter than their normally erupted contralateral teeth.
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Affiliation(s)
| | | | | | | | - Heraldo Luis Dias-Da Silveira
- Department of Oral Surgery and Orthopedics, Division of Dental Radiology, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Vinicius Dutra
- Department of Oral Pathology, Medicine, and Radiology, School of Dentistry, Indiana University, Indiana, USA
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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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Pan W, Yu L, Chen S, Zhou J, Chi J, Voliere G, Du W, Gong Y, Lin H, Hu R. Morphometric evaluation of alveolar bone after orthodontic treatment of multiple impacted teeth in the unilateral maxillary anterior region. Am J Orthod Dentofacial Orthop 2023; 164:783-792. [PMID: 37498252 DOI: 10.1016/j.ajodo.2023.05.027] [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: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION This study aimed to investigate the height and thickness of alveolar bone by cone-beam computed tomography imaging after orthodontic treatment in the unilateral maxillary anterior region and speculate on reasons for the difference in alveolar bone morphology. METHODS This study selected 11 patients (3 males and 8 females; mean age, 9.42 ± 1.45 years). Cone-beam computed tomography was performed for these 11 patients before and after treatment using Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). Labial and palatal alveolar bone thickness (BT) at root apices and different levels along the roots and loss of alveolar bone height was measured for each impacted tooth and its contralateral homonymous tooth. RESULTS After orthodontic therapy, all 3 impacted anterior teeth had different degrees of loss of labial alveolar bone height compared with the normal side (central incisor: -1.5 mm, P <0.005; lateral incisor: -1.06 mm, P <0.01; canine: -0.59 mm, P < 0.01). The lateral incisors also showed palatal alveolar bone height loss compared with the unaffected side (-0.8 mm, P <0.005). Alveolar BT at root apices of impacted canines was 1.14 mm thicker than the normal side (P <0.005). Central and lateral incisors were similar to the normal side. The thickness of the alveolar bone at 8, 10, and 12 mm of the impacted canine position was still larger than that on the healthy side, whereas the difference in average thickness between the healthy and affected side had been significantly reduced compared with pretreatment measurements. CONCLUSIONS There is satisfactory retention of alveolar bone height in canines after orthodontic treatment; however, alveolar bone loss is slightly worse at central and lateral incisors. Retention of alveolar BT was normal for impacted anterior teeth, whereas excess apical alveolar BT at the canines, although still present, was substantially less significant than had been observed before treatment.
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Affiliation(s)
- Wenhao Pan
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Liyun Yu
- Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Siyun Chen
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jianan Zhou
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jun Chi
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Gerald Voliere
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wulong Du
- Department of Stomatology, Lishui Central Hospital/The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
| | - Yixuan Gong
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Haisheng Lin
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China.
| | - Rongdang Hu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Hu H, Hu R, Wu G, Sun C. The evaluation of lateral incisor adjacent to treated labial inversely impacted maxillary central incisor: A retrospective follow-up study. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00062-8. [PMID: 36842949 DOI: 10.1016/j.ajodo.2022.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 02/28/2023]
Abstract
INTRODUCTION This retrospective study aimed to evaluate the further development of the lateral incisor and its associated periodontium adjacent to the treated labial inversely impacted maxillary central incisor. METHODS We enrolled 23 participants (average age, 8.24 ± 1.43 years) undergoing a mean follow-up period of 31.10 ± 13.05 months. Each participant had an unimpacted lateral incisor and a successfully treated unilateral labial inversely impacted maxillary central incisor. The contralateral lateral incisors served as controls. Cone-beam computed tomography data were available for treatment completion and follow-up stages. The variables (including root length, dental age, root canal width, root-crown angulation, and alveolar bone loss and thickness) were evaluated with Dolphin Imaging software (version 11.95; Dolphin Imaging and Management Solutions, Chatsworth, Calif). RESULTS At the follow-up stage, the lateral incisors in the impacted side had significantly longer root lengths, smaller root canal widths, and thinner labial bone widths at the apex than at the posttreatment stage (P <0.001, P = 0.036, and P = 0.001, respectively). A significant lateral incisor root length reduction was noted when comparing the impacted and contralateral sides, although no variation was observed in root canal width. Similarly, crown-root angulation of the lateral incisor on the impacted side was significantly larger than that of the contralateral lateral incisor. The lateral incisor on the impacted side also had thicker labial and thinner lingual bone widths at the apex than the contralateral lateral incisor. CONCLUSIONS The lateral incisor adjacent to the successfully treated labial inversely impacted maxillary central incisor showed continuous growth during follow-up stages, exhibiting a similar morphology and alveolar bone quality but shorter root length, larger root angulation, and thinner lingual bone width at the apex than those of the contralateral lateral incisors.
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Affiliation(s)
- Han Hu
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rongdang Hu
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Guosheng Wu
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaofan Sun
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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The effect of the root dilaceration on the treatment duration and prognosis of unilateral impacted immature maxillary central incisors. Am J Orthod Dentofacial Orthop 2023; 163:79-86. [PMID: 36202699 DOI: 10.1016/j.ajodo.2021.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This study aimed to investigate the effect of root dilaceration on the closed-eruption technique treatment and prognosis on impacted immature maxillary central incisors. METHODS In this retrospective study, we compared the age at the beginning of the treatment, the treatment duration, root development, and alveolar bone mass after the closed-eruption technique between the impacted immature maxillary central incisors with dilacerated roots (group 1) and those with straight roots (group 2). RESULTS The mean age at the time of the surgery of group 1 was 0.9 years younger than that of group 2 (P = 0.008). The mean traction time was greater in group 1 (8.0 ± 1.8 months), with a difference of 1.4 months than in group 2 (6.6 ± 2.1 months) (P = 0.042). The measurements of lingual bone thickness at the alveolar crest (C) showed significant differences between the 2 groups (P = 0.025). No significant differences were found in other treatment duration or measurements of root development and alveolar bone mass between the 2 groups. CONCLUSIONS Patients with impacted immature incisors with dilacerated roots were younger at the beginning of the closed-eruption treatment and had a longer traction time than those with impacted immature incisors having straight roots. The root dilaceration had little or no effect on root development and alveolar bone mass after the closed-eruption treatment. The closed-eruption treatment of impacted immature incisors with root dilaceration is suggested to commence as early as possible.
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Orthodontic management of a horizontally impacted maxillary incisor in an adolescent patient. Am J Orthod Dentofacial Orthop 2023; 163:126-136. [PMID: 36192324 DOI: 10.1016/j.ajodo.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 12/27/2022]
Abstract
Horizontal maxillary incisor impaction is not common, but it affects facial esthetics, phonetics, and the patient's self-esteem. Therefore, it is necessary to manage this problem as early as possible. This case report presents a patient with an unerupted maxillary left central incisor combined with anterior and left posterior crossbite, edge-to-edge overbite on the right and left anterior open bite, low smile line, and mild skeletal Class III discrepancy. The treatment consisted of 3 stages: (1) maxillary expansion and sufficient space creation for the impacted tooth; (2) surgical exposure by closed-eruption technique; and (3) induced eruption of impaction. The treatment outcome was highly favorable. Maxillary impaction erupted in the proper position with a normal clinical crown height and consonant gingival line with the adjacent teeth. Maxillary and mandibular teeth had normal and stable occlusion. The 3-year follow-up demonstrated an esthetically functional outcome after orthodontically induced tooth eruption. This treatment required a good treatment plan by the orthodontist to obtain satisfactory results.
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Du W, Chi J, He S, Wu G, Pan W, Wang Y, Voliere G, Hu R. The position and morphology characteristics of multiple impacted anterior teeth in the unilateral maxillary area: A retrospective study based on cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2022; 162:907-916. [PMID: 36123228 DOI: 10.1016/j.ajodo.2021.07.028] [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: 01/11/2021] [Revised: 07/09/2021] [Accepted: 07/18/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study investigated the position and morphologic characteristics of multiple impacted anterior teeth in the unilateral maxillary area. METHODS Cone-beam computed tomography images of 21 patients (11 males and 10 females; median age 9.42 years [9.08-11.29]) with multiple teeth impacted were collected and imported into Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). The vertical height, crown orientation, twist direction, and root curvature of each impacted tooth were described. The crown length, root length, and root canal width of impacted and homonym teeth were measured. RESULTS The positions of the impacted lateral incisors are lower than that of the other 2 anterior teeth. Most crowns of impacted central incisors are positioned distally, labial surfaces in mesial torsion, with most roots, bent toward the distal and labial. Crowns of impacted lateral incisors are positioned mesiolabially, with labial surfaces mostly in distal torsion, and most roots bent toward the mesial and labial. Crowns of impacted canines are mostly positioned mesiolabially, with labial surfaces in mesial torsion. The crowns and roots of the impacted central and lateral incisors were shorter than those of the homonym (P <0.05); however, the difference in crown length is clinically negligible, and there was no difference in root canal widths. There was no difference in the comparison of parameters for the canine group. CONCLUSIONS There are certain rules in the vertical height, crown orientation, twist direction, and root curvature of multiple impacted anterior teeth in the unilateral maxillary area. Root development of impacted central and lateral incisors was restricted.
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Affiliation(s)
- Wulong Du
- Department of Stomatology, Lishui Central Hospital/the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
| | - Jun Chi
- Department of Stomatology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Shengxi He
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guosheng Wu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wenhao Pan
- Department of Stomatology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Yi Wang
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Gerald Voliere
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rongdang Hu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Lana Mattiello FD, Deon Rizzatto SM, Macedo de Menezes L, Araújo EA, Kim KB, Martinelli de Lima E. Dimensional and morphologic characteristics of unilateral impacted maxillary central incisors. Am J Orthod Dentofacial Orthop 2022; 162:340-347. [PMID: 35568599 DOI: 10.1016/j.ajodo.2021.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This cross-sectional study aimed to investigate the crown and root characteristics of impacted central incisors compared with spontaneously erupted contralateral incisors and the influence of etiologic and local factors on their dimensions. METHODS Forty-five patients (22 boys, 23 girls) who underwent orthodontic treatment for unilateral impaction of maxillary central incisors were referred for cone-beam imaging. Dimensions of the impacted and contralateral incisors were assessed using Dolphin 3D software (Dolphin Imaging & Management Solutions, Chatsworth, Calif). Paired t test and linear regression were used to compare the characteristics of the impacted and contralateral teeth. RESULTS Contralateral and impacted central incisors showed statistically significant differences for root length (95% confidence interval [CI], 2.32-3.46; P <0.001), mesiodistal crown-root angulation (95% CI, 4.09-15.95; P = 0.001), and labiolingual crown-root angulation (95% CI, -18.69 to -4.70; P = 0.002). Etiologic factors did not alter the dimensions of incisors (95% CI, -1.17 to 0.76; P = 0.672). According to the multiple linear regression the independent variables associated with root length of contralateral and impacted incisors were sex (β = -0.904; 95% CI, -1.62 to - 0.19; P = 0.014) and the presence of impaction (β = -2.87; 95% CI, -3.67 to -2.07; P <0.001). CONCLUSIONS Regardless of their etiology, the impacted incisors showed roots that were 2.89 mm shorter than the contralateral incisors and had greater angulation in the mesiodistal and labiolingual directions. Girls showed a reduction of 0.904 mm (7.6%) on the lengths of roots of both impacted and contralateral central incisors. The presence of impaction led to a reduction of 25% in incisor root lengths. Approximately 30% of the impacted teeth showed crown-root angulations >20° resulting in an increased distal and labial angulation of the root apical portion.
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Affiliation(s)
- Fabiano Dalla Lana Mattiello
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Susana Maria Deon Rizzatto
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciane Macedo de Menezes
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eustáquio Afonso Araújo
- Department of Orthodontics, School of Dentistry, Saint Louis University, St Louis, Mo, Brazil
| | - Kim Beom Kim
- Department of Orthodontics, School of Dentistry, Saint Louis University, St Louis, Mo, Brazil
| | - Eduardo Martinelli de Lima
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Calil LR, Janson G, Silva VMD, Freitas MRD, Almeida ALPFD, Garib D. Periodontal status of maxillary central incisors after orthodontic traction: a longitudinal follow-up. J Appl Oral Sci 2022; 30:e20210492. [PMID: 35352790 PMCID: PMC8983035 DOI: 10.1590/1678-7757-2021-0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/04/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the clinical and radiographic periodontal status of impacted permanent maxillary central incisors (Mx.1) after a long term of orthodontic traction. METHODOLOGY This split-mouth study evaluated a sample of 11 patients (five females, six males) treated with Mx.1 unilateral traction one to 28 years after the removal of orthodontic appliances. The traction Group (TG) consisted of 11 Mx.1 and the Comparison Group (CG) comprised 11 spontaneously erupted contralateral Mx.1. High-resolution CBCT exams of central incisors were performed using Accuitomo (J. Morita, Kyoto, Japan). Cross-section imagens passing through the center of maxillary central incisors were used to measure buccal and lingual alveolar bone level. Presence of fenestration, root dilacerations, root coverage, and position of the root apex were also assessed in the same images. Clinical parameters included periodontal probing depth, attachment level, gingival bleeding index, plaque index, degree of gingival recession, amount of gingival mucosa, and evaluation of interproximal papilla and black triangle. Digital model analysis included an assessment of clinical crown height and width. Intergroup comparisons were performed using paired t-, McNemar's, and Wilcoxon tests (p<0.05). RESULTS Compared to CG, we found a significantly thinner labial bone plate thickness in TG at the middle (p=0.000) and apical (p=0.009) root level. We also observed an apical displaced labial bone crest level in TG (p=0.000). The Traction Group showed a greater frequency of root dilacerations and gingival recessions, a decreased amount of keratinized mucosa, and a decreased clinical attachment level at the labial aspect compared to contralateral teeth. CONCLUSIONS A decreased thickness and height of labial alveolar bone and gingival recessions were found in maxillary central incisors 15 years after orthodontic traction. Though incisor traction might cause some periodontal impact, differences are acceptable under a clinical point of view considering the cost-benefit ratio.
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Affiliation(s)
- Louise Resti Calil
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Vinicius Merino da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Marcos Roberto de Freitas
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | | | - Daniela Garib
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
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The Morphology of Impacted Maxillary Central Incisors: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58040462. [PMID: 35454301 PMCID: PMC9026335 DOI: 10.3390/medicina58040462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: The knowledge of the morphology of impacted maxillary central incisors may lead to more effective treatment. Therefore, this systematic review aimed to evaluate the morphology of impacted maxillary central incisors and compare them with contralateral teeth. Material and methods: This systematic review adhered to the PRISMA statement. The literature search was carried out using PubMed (Medline database), Cochrane Library, ProQuest, Web of Science and Science Direct electronic databases with no publication date restrictions up to July 2021. Data assessing the morphology of unilaterally impacted maxillary central incisors (ICI) evaluated with CBCT were extracted, and the quality of the studies was evaluated. Crown length, root length, and root dilaceration of impacted maxillary central incisors were compared with contralateral unimpacted teeth. Results: The initial database search identified a total number of 287 studies. After applying the selection criteria, 21 articles were selected for a full-text analysis, and four retrospective studies involving 205 patients were included in the systematic review. According to the Newcastle-Ottawa Scale (NOS), two of included articles were graded as “Good” and the remaining two as “Fair” quality. The results showed no difference between impacted teeth and their contralateral crowns, or a minor decrease in ICI crown length (from 0.15 to 0.56 mm). The root lengths of impacted maxillary central incisors were considerably shorter than contralateral incisors (from 2.13 to 3.22 mm) and, as dental age increased, root growth decreased and the incidence of root dilaceration was more frequent. Conclusions: The root lengths of impacted maxillary central incisors were considerably shorter compared to the contralateral incisors. Root dilacerations frequency and severity increased as dental age increased.
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Sánchez-Achío T. [Traction of a superior central incisive in ectopic position with a modified hawley appliance: a clinical case report]. REVISTA CIENTÍFICA ODONTOLÓGICA 2022; 10:e101. [PMID: 38389915 PMCID: PMC10880709 DOI: 10.21142/2523-2754-1001-2022-101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/21/2022] [Indexed: 02/24/2024] Open
Abstract
The prevalence of impaction of the permanent maxillary incisors ranges from 0.06 to 1% of the population. One of the possible causes of impaction of the upper central incisor is the presence of an odontoma. The objective of this clinical case study was to propose an orthodontic treatment proposal for a girl with early mixed dentition, pulling an impacted maxillary central incisor, a rare problem in the population, caused by the presence of a compound odontoma. A 6- year-old and 2-month-old female patient presented to the private consultation. On clinical examination, she showed a delay in exfoliation of the teeth 5.1 and 5.2, the panoramic radiograph revealed the presence of a compound odontoma. And in the tomography, the dental piece 1.1 was observed in an ectopic position, horizontal in the sagittal plane. The composite odontoma was removed at the same time as the retained tooth was exposed, and it was decided to use a modified Hawley, type removable appliance with a tower to perform traction of the tooth. The choice of good diagnosis of bone pathologies and dental alterations. The patient presented an impaction of tooth 1.1 and due to her early mixed dentition, it was not possible to treat it conventionally with fixed bracket appliances, reason why it was decided to make a modified Hawley type removable appliance. The treatment time for dental traction was 8 months, a relatively short time, according to the literature.
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Affiliation(s)
- Tony Sánchez-Achío
- Departamento de Odontopediatría y Ortodoncia, Universidad de Costa Rica. San José, Costa RicaUniversidad de Costa RicaDepartamento de Odontopediatría y OrtodonciaUniversidad de Costa RicaSan JoséCosta Rica
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Wu G, He S, Chi J, Sun H, Ye H, Bhikoo C, Du W, Pan W, Voliere G, Hu R. The differences of root morphology and root length between different types of impacted maxillary central incisors: A retrospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2022; 161:548-556. [DOI: 10.1016/j.ajodo.2020.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/01/2022]
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Post-Treatment Status of Impacted Maxillary Central Incisors following Surgical-Orthodontic Treatment: A Systematic Review. MEDICINA-LITHUANIA 2021; 57:medicina57080783. [PMID: 34440987 PMCID: PMC8401854 DOI: 10.3390/medicina57080783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The aim of this systematic review was to summarize currently available data of published articles that have investigated the post-treatment status of impacted maxillary central incisors (ICI) treated by the surgical-orthodontic approach. Materials and Methods: MEDLINE, Scopus, Cochrane Oral Health Group’s Trials Register, and ScienceDirect electronic databases were systematically searched with no publication date restrictions up to January 2021. Data assessing the status of ICI after combined surgical-orthodontic treatment and forced eruption duration were extracted, and the quality of the studies was evaluated. Results: In total, 7074 studies were identified, of which 42 articles were assessed for eligibility through full-text evaluation. Seven included studies (five retrospective studies, one randomized clinical trial, and one prospective clinical trial) met the inclusion criteria, representing 211 patients with unilaterally impacted maxillary incisors. The risk of bias ranged from moderate to high. The results show that the root length of immature ICIs increased significantly but remained shorter than that of homonym teeth at post-treatment. Periodontal parameters of treated ICIs were in a clinically acceptable range. Measurements of the alveolar bone showed a reduction of bone thickness and support. The average forced eruption duration ranged from 8.0 ± 4.5 to 14.41 ± 4.03 months. Conclusions: Based on existing evidence, it is reasonable to conclude that the surgical-orthodontic treatment affected the post-treatment status of ICI; however, the current literature is insufficient to draw concrete conclusions. Further well-conducted multi-center randomized studies with a large sample are needed to confirm this statement.
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Bhikoo C, Xu J, Sun H, Jin C, Jiang H, Hu R. Factors affecting treatment duration of labial inversely impacted maxillary central incisors. Am J Orthod Dentofacial Orthop 2018; 153:708-715. [DOI: 10.1016/j.ajodo.2017.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 01/10/2023]
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HARD PALATE DEVELOPMENT AND STRUCTURE FORMING IN THE FIRST TRIMESTER OF THE INTRAUTERINE DEVELOPMENT PERIOD. WORLD OF MEDICINE AND BIOLOGY 2018. [DOI: 10.26724/2079-8334-2018-4-66-194-197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Survival of labial inversely impacted maxillary central incisors: A retrospective cone-beam computed tomography 2-year follow-up. Am J Orthod Dentofacial Orthop 2017; 151:860-868. [DOI: 10.1016/j.ajodo.2016.10.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/23/2022]
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