Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes-a multicentre, randomized controlled trial

Evaluating the success rates and effectiveness of surgical and orthodontic interventions for impacted canines: a systematic review of surgical and orthodontic interventions and a case series

OBJECTIVES

The goal is to gather more information on orthodontic traction of impacted canines in the arch or their extraction.

METHODS

We focused our search on English-language papers published between January 1, 2004, and July 24, 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. The search strategy employed the Boolean terms "impacted" AND "canine". In addition to the overview, this article discusses a number of clinical instances involving canine disinclusion.

RESULTS

The study analyzed 2748 papers from databases like Web of Science, PubMed, and Scopus, resulting in 1455 articles after eliminating duplicates. After examining titles and abstracts, 897 entries were removed. The remaining 558 papers were confirmed, with 543 items removed due to being off-topic. The study includes a qualitative analysis of the 15 final articles.

CONCLUSIONS

This article concludes that both extraction and orthodontic traction are effective treatments for impacted canines, with the choice depending on patient-specific factors. Advances in surgical techniques and imaging technologies have improved outcomes, while a multidisciplinary, patient-centered approach remains essential. Future research should focus on refining treatment selection criteria and integrating genetic and technological advancements.

Periodontal and orthodontic management of impacted canines

The maxillary and mandibular canines are described by many clinicians as the "cornerstone" of the arch. When in their optimal position, they play a critical role in providing a well-balanced occlusal scheme that contributes toward functional as well as neuromuscular stability, harmony, esthetics, and dentofacial balance. When an aberration is noted with the normal eruptive and development process, early diagnosis with strategic intervention is critical and may often require a multidisciplinary approach. A proper diagnosis, risk assessment, and management of the soft tissues, hard tissues, and adjacent structures are vital for a successful outcome. This review highlights the diagnostic and treatment modalities that require consideration for the orthodontic as well as the periodontal management of impacted canines. The reader is guided through the etiology, diagnosis, prevention, and intervention of clinical cases that were managed with different approaches.

The effect of orthodontic tooth movement on the sensitivity of dental pulp: A systematic review and meta-analysis

Objectives

Orthodontic tooth movement (OTM) is a process that's initiated by orthodontic forces. As a consequence, the forces could restrict pulpal blood supply, possibly affecting dental pulp. The study aimed to review the available evidence on the short and long-term effects of orthodontic tooth movement on dental pulp sensitivity and to identify clinically relevant risk factors.

Sources

PubMed, Embase, Scopus, and Web of Science were searched for papers from 1990 to the end of December 2021.

Study selection

The studies that evaluated dental pulp sensitivity of teeth undergoing OTM were included in the systematic review. Randomized, nonrandomized and case-controlled studies were included in the analysis. Risk of bias in each study was assessed using the ROBINS-I tool.

Data

The systematic search yielded an initial sample of 1110 studies, 17 were included in qualitative analysis. Most studies were classified as moderate risk of bias, however only limited long-term evidence with a higher risk of bias exists. Electric pulp test (EPT) sensitivity threshold during active OTM was increased by 4.25 SD (P < 0.001) and the relative risk (RR) of pulpal non-sensitivity was 13.27 (P < 0.001) higher compared to pre-orthodontic baseline status. Significant differences were between subgroups associated with the type of OTM. A positive relationship between pulpal non-sensitivity and mean patient age was discovered (P = 0.041). After OTM the risk of pulpal non-sensitivity remained 5.76 times higher (P < 0.001) in the long term.

Conclusions

Evidence showed that OTM could affect dental pulp sensitivity. The type of OTM and patients' age were identified as clinically relevant risk factors.

Clinical significance

Orthodontic tooth movement negatively impacts the sensitivity of dental pulp during active treatment and to a lesser degree in the long term. Pulpal sensitivity tests during active OTM should therefore be interpreted with caution. Data indicates younger patients have a lower risk of negative pulpal sensitivity during orthodontic treatment.

Midfacial development and the wisdom of teeth: A case series

The alignment of third molars has largely been overlooked by orthodontists. Since difficulties arise during their eruption, a plethora of surgical procedures is advocated for their management, including prophylactic extraction. This case series describes the use of midfacial development in 4 patients and illustrates successful patterns of third molar eruption.