Dental follicles promote soft tissue management in surgical exposure of labially impacted maxillary canine

Periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines: A systematic review and meta-analysis

OBJECTIVE

This systematic review aimed to compare periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines to spontaneously erupted maxillary canines.

DATA SOURCES

An unrestricted search was carried out of indexed databases (Medline, EMBASE, Web of Science and Scopus), reference lists of included studies, and grey literature published until December 2023.

DATA SELECTION

Observational and experimental studies that addressed the focused question 'Do periodontal outcomes of buccally impacted maxillary canines that were surgically exposed and subsequently extruded and aligned using orthodontic alignment differ from those of spontaneously erupted maxillary canines?' were included.

DATA EXTRACTION

Study screening, selection and data extraction were performed independently by two authors, with disagreement resolved by a third reviewer. The risk of bias was assessed using the JBI Critical Appraisal Checklist and GRADE approach.

RESULTS

A total of 857 citations were found and five studies were eligible for inclusion. Supragingival plaque accumulation and gingival inflammation were similar between impacted canines and their contralaterals in most studies. Meta-analyses revealed no significant differences in keratinised tissue width (prospective studies: MD = -0.28, 95% confidence interval [CI] = -1.13-0.56, I² = 78%; retrospective studies: MD = 0.61, 95% CI = -1.51-2.72, I² = 94%). However, a meta-analysis of prospective studies showed slightly greater mean probing depth for impacted canines compared to their contralateral canines (prospective studies: MD = 0.16, 95% CI = 0.04-0.28, I² = 0%). The evidence certainty for keratinised tissue width and probing depth outcomes was low.

CONCLUSION

Surgically exposed and orthodontically aligned buccally impacted canines have slightly greater probing depths, potential bone loss and increased clinical crown length, compared to their counterparts. However, these small differences (<1 mm) are unlikely to be clinically significant.

Orthodontic traction of an impacted maxillary third molar through a miniscrew-anchored cantilever spring to substitute the adjacent second molar with severe root resorption

BACKGROUND

An orthodontic traction technique with a miniscrew-anchored cantilever spring was used for the traction of a deeply impacted maxillary third molar to substitute its adjacent second molar with severe root resorption.

CASE DESCRIPTION

A 30-year-old woman sought multidisciplinary treatment planning for a second molar with severe root resorption caused by a deeply impacted third molar. Panoramic radiographs and cone-beam computed tomographic images showed that the third molar was located on the apical and palatal side of the second molar and that the second molar had severe root resorption. The second molar was removed, and the impacted third molar was orthodontically tractioned occlusally with the aid of a miniscrew-anchored cantilever spring. After 12 months of orthodontic treatment, the maxillary left third molar was successfully tractioned occlusally and well aligned with adjacent teeth for the substitution of the second molar. The patient was satisfied with the treatment outcome.

PRACTICAL IMPLICATIONS

A palatal miniscrew-anchored cantilever spring is an effective and viable technique for the orthodontic traction of deeply impacted third molars to substitute second molars with severe root resorption.