Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/20.500.11816/4503 |
Resumo: | Introduction: Maxillary canines play a very important esthetic and functional role in permanent dentition. This set of teeth is the second most frequently impacted after the third molar and most commonly ectopically erupting amongst the others. Untreated displaced canines often result in impaction. Consequently, causing various complications such as follicular cyst, ankylosis, impacted cuspid root resorption as well as resorption of the roots of neighboring teeth (67% chance of resorption for lateral incisors root and 11.1 % for central incisors roots). Orthodontic treatment of impacted canine intraosseous malposition is very challenging, which requires surgical exposure followed by a long duration orthodontics traction, with possible complications or failure to erupt. Early diagnostic could enable interceptive treatment option to facilitate successful eruption of palatally displaced canines and avoid long and traumatic treatment time and pathological complications. Objective: Systematic review on effectiveness of various interceptive treatments of palatally displaced canines, such as: extraction of deciduous canine, extraction of deciduous canine and first deciduous molar, Rapid Maxillary Expansion (RME), Transpalatal Arch (TPA) and cervical pull headgear as well as combination of these approaches in children between 8 - 14 years of age. Furthermore, to determine whether mentioned interceptive treatments will increase chance of successful eruption of palatally displaced permanent canines. Methodology: Digital repository: PubMed, Web of Science, Cochrane Library, Clinical Trials. Selected articles were in English and French published between January 2000 – June 2023. Which included randomized controlled trials, non-randomized control trials (RCT) and longitudinal studies on palatally displaced canines in children between 8 and 14 years of age, that did not previously have orthodontics treatment nor envisaged surgically assisted one. Result: Eight articles were selected amongst which; seven were Randomized Controlled Trials (RCT) and one – a Prospective Longitudinal Study. Qualitative assessment was done for all the eight studies. The following interceptive treatment protocols were experimented: single deciduous canine extraction, double extraction of deciduous canine and primary first molar, additional orthodontic appliances treatment (RME, TPA, Cervical Pull Headgear) in combination with or without deciduous canine extraction. The successful eruption result rages between 50% to 97.3%, depending on the method, in comparison to 25 % - 48% in control groups. Conclusion. Even though various interceptive treatments of palatally displaced cuspids demonstrate diverse results of effectiveness, due to important difference in sample sizes and, in two RCT, lack of control group or non-randomized allocation of subjects to the control group, makes it difficult to draw a meaningful evidence-based conclusions in two of reviewed studies. Based on the published data, the most notable result with strong evidence was reported in the subjects treated with deciduous canine extraction in combination with Cervical Pull Headgear usage. It would appear that, additional application of orthodontic forces restricts physiological mesial movement of the first maxillary permanent molars. Consequently, ensuring the space maintenance and/or improvement of the upper arch permitter by preventing maxillary distal segment from anterior sagittal displacement. Therefore, preserving necessary space for palatally displaced canine to erupt. Despite demonstration of significant success rate of palatally displaced canine eruption, additional well designed RCT with proper randomization and larger sample sizes would provide more evidence-based data. |
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Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years oldPalatally displaced caninesPalatally impacted caninesInterceptivePreventiveSpontaneous eruptionExtractionRMEHeadgearIntroduction: Maxillary canines play a very important esthetic and functional role in permanent dentition. This set of teeth is the second most frequently impacted after the third molar and most commonly ectopically erupting amongst the others. Untreated displaced canines often result in impaction. Consequently, causing various complications such as follicular cyst, ankylosis, impacted cuspid root resorption as well as resorption of the roots of neighboring teeth (67% chance of resorption for lateral incisors root and 11.1 % for central incisors roots). Orthodontic treatment of impacted canine intraosseous malposition is very challenging, which requires surgical exposure followed by a long duration orthodontics traction, with possible complications or failure to erupt. Early diagnostic could enable interceptive treatment option to facilitate successful eruption of palatally displaced canines and avoid long and traumatic treatment time and pathological complications. Objective: Systematic review on effectiveness of various interceptive treatments of palatally displaced canines, such as: extraction of deciduous canine, extraction of deciduous canine and first deciduous molar, Rapid Maxillary Expansion (RME), Transpalatal Arch (TPA) and cervical pull headgear as well as combination of these approaches in children between 8 - 14 years of age. Furthermore, to determine whether mentioned interceptive treatments will increase chance of successful eruption of palatally displaced permanent canines. Methodology: Digital repository: PubMed, Web of Science, Cochrane Library, Clinical Trials. Selected articles were in English and French published between January 2000 – June 2023. Which included randomized controlled trials, non-randomized control trials (RCT) and longitudinal studies on palatally displaced canines in children between 8 and 14 years of age, that did not previously have orthodontics treatment nor envisaged surgically assisted one. Result: Eight articles were selected amongst which; seven were Randomized Controlled Trials (RCT) and one – a Prospective Longitudinal Study. Qualitative assessment was done for all the eight studies. The following interceptive treatment protocols were experimented: single deciduous canine extraction, double extraction of deciduous canine and primary first molar, additional orthodontic appliances treatment (RME, TPA, Cervical Pull Headgear) in combination with or without deciduous canine extraction. The successful eruption result rages between 50% to 97.3%, depending on the method, in comparison to 25 % - 48% in control groups. Conclusion. Even though various interceptive treatments of palatally displaced cuspids demonstrate diverse results of effectiveness, due to important difference in sample sizes and, in two RCT, lack of control group or non-randomized allocation of subjects to the control group, makes it difficult to draw a meaningful evidence-based conclusions in two of reviewed studies. Based on the published data, the most notable result with strong evidence was reported in the subjects treated with deciduous canine extraction in combination with Cervical Pull Headgear usage. It would appear that, additional application of orthodontic forces restricts physiological mesial movement of the first maxillary permanent molars. Consequently, ensuring the space maintenance and/or improvement of the upper arch permitter by preventing maxillary distal segment from anterior sagittal displacement. Therefore, preserving necessary space for palatally displaced canine to erupt. Despite demonstration of significant success rate of palatally displaced canine eruption, additional well designed RCT with proper randomization and larger sample sizes would provide more evidence-based data.Introdução: Caninos maxilares permanentes têm um papel importante não só na estética mas também funcional na dentição permanente.Este é o segundo conjunto de dentes mais impactado, a seguir ao terceiro molar, e o que mais erupção ectópica tem de toda a dentição. Caninos retidos sem tratamento geralmente resultam em impactação, muitos podem causar diversas complicações como cisto folicular, anquilose, reabsorção do cúspido impactado bem como dos seus dentes vizinhos (66.7% chance de absorção das raízes de um incisivo lateral, 11% das raízes de um incisivo central). O tratamento da malposição intraóssea desse canino é bastante complicado, o que requer exposição cirúrgica seguido de um tração ortodôntico de longa duração, com possíveis complicações ou falha de erupção. Um diagnóstico precoce permite uma opção de tratamento interceptivo, o que facilita uma erupção com sucesso dos caninos retidos por palatino e evitar um tratamento longo e traumático com complicações patológicas. Objetivos: Revisão Sistemática sobre a eficácia de diferentes tratamentos de caninos retidos por palatino, tais como: Extração do canino decíduo e primeiro molar decíduo, Expansão Maxilar Rápida (RME), Arco Transpalatal (TPA) e aparelho extrabucal com tração baixa, tal como qualquer combinação destes procedimentos, em crianças entre os 8 e 14 anos de idade. Para além disso, determinar se os estes tratamentos interceptivos aumentam as chances de erupção espontânea de cúspides permanentes retidos por palatino. Metodologia: Repositório digital: PubMed, Web of Science, Cochrane Library, Clinical Trials. Os artigos selecionados encontram-se em inglês e francês, publicados entre janeiro 2000 e junho 2023. Estes incluem ensaios clínicos randomizados, ensaios clínicos não-randomizados (RCT) e estudos longitudinais em caninos retidos por palatino em crianças entre 8 e 14 anos de idade, que não tiveram tratamento ortodôntico anterior nem é previsto ser assistido cirurgicamente. Resultado: Foram selecionados oito artigos, dentro dos quais, sete eram ensaios controlados randomizados (RCT) e um estudo prospectivo longitudinal. A análise qualitativa foi feita para todos os oito estudos. Os seguintes protocolos de tratamento interceptativo foram estudados: extração única de canino decíduo, extração dupla de canino decíduo e primeiro molar decíduo, tratamento com aparelhos ortodônticos adicionais (RME, TPA, Cervical Pull Headgear) em combinação com ou sem extração de canino decíduo. O resultado da erupção com sucesso varia entre 50% a 97,3%, dependendo do método, – em comparação, com 25% - 48% nos grupos de controle. Conclusão: Mesmo que vários tratamentos interceptativos de cúspides retidos palatinamente demonstrem resultados diversos de eficácia, devido à importante diferença nos tamanhos das amostras e, em dois RCT, falta de grupo de controlo ou alocação não randomizada de indivíduos para o grupo de controlo, torna-se difícil traçar conclusões significativas baseadas em evidência em dois dos estudos revisados. Com base nos dados publicados, o resultado mais notável baseado em evidências foi relatado em indivíduos tratados com extração de caninos decíduos em combinação com o uso de aparelho extrabucal com tração baixa. Parece que a aplicação adicional de forças ortodônticas restringe o movimento mesial fisiológico dos primeiros molares superiores permanentes. Consequentemente, garantir a manutenção do espaço e/ou melhoria do arco superior permite evitar que o segmento distal da maxila tenha deslocamento sagital anterior. Portanto, preservando o espaço necessário para a erupção do canino retido por palatino. Apesar da demonstração de taxa de sucesso significativa de erupção canina deslocada palatinamente, um RCT adicional bem desenhado com amostras aleatórias adequadas e tamanhos amostrais maiores, forneceriam mais dados baseados em evidências.2024-02-15T13:59:58Z2023-01-01T00:00:00Z2023info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/20.500.11816/4503TID:203526430engElovikova, Irynainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-02-22T09:05:05Zoai:repositorio.cespu.pt:20.500.11816/4503Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:10:45.204119Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
title |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
spellingShingle |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old Elovikova, Iryna Palatally displaced canines Palatally impacted canines Interceptive Preventive Spontaneous eruption Extraction RME Headgear |
title_short |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
title_full |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
title_fullStr |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
title_full_unstemmed |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
title_sort |
Effectiveness of various interceptive treatments of palatally displaced canines in children between 8 and 14 years old |
author |
Elovikova, Iryna |
author_facet |
Elovikova, Iryna |
author_role |
author |
dc.contributor.author.fl_str_mv |
Elovikova, Iryna |
dc.subject.por.fl_str_mv |
Palatally displaced canines Palatally impacted canines Interceptive Preventive Spontaneous eruption Extraction RME Headgear |
topic |
Palatally displaced canines Palatally impacted canines Interceptive Preventive Spontaneous eruption Extraction RME Headgear |
description |
Introduction: Maxillary canines play a very important esthetic and functional role in permanent dentition. This set of teeth is the second most frequently impacted after the third molar and most commonly ectopically erupting amongst the others. Untreated displaced canines often result in impaction. Consequently, causing various complications such as follicular cyst, ankylosis, impacted cuspid root resorption as well as resorption of the roots of neighboring teeth (67% chance of resorption for lateral incisors root and 11.1 % for central incisors roots). Orthodontic treatment of impacted canine intraosseous malposition is very challenging, which requires surgical exposure followed by a long duration orthodontics traction, with possible complications or failure to erupt. Early diagnostic could enable interceptive treatment option to facilitate successful eruption of palatally displaced canines and avoid long and traumatic treatment time and pathological complications. Objective: Systematic review on effectiveness of various interceptive treatments of palatally displaced canines, such as: extraction of deciduous canine, extraction of deciduous canine and first deciduous molar, Rapid Maxillary Expansion (RME), Transpalatal Arch (TPA) and cervical pull headgear as well as combination of these approaches in children between 8 - 14 years of age. Furthermore, to determine whether mentioned interceptive treatments will increase chance of successful eruption of palatally displaced permanent canines. Methodology: Digital repository: PubMed, Web of Science, Cochrane Library, Clinical Trials. Selected articles were in English and French published between January 2000 – June 2023. Which included randomized controlled trials, non-randomized control trials (RCT) and longitudinal studies on palatally displaced canines in children between 8 and 14 years of age, that did not previously have orthodontics treatment nor envisaged surgically assisted one. Result: Eight articles were selected amongst which; seven were Randomized Controlled Trials (RCT) and one – a Prospective Longitudinal Study. Qualitative assessment was done for all the eight studies. The following interceptive treatment protocols were experimented: single deciduous canine extraction, double extraction of deciduous canine and primary first molar, additional orthodontic appliances treatment (RME, TPA, Cervical Pull Headgear) in combination with or without deciduous canine extraction. The successful eruption result rages between 50% to 97.3%, depending on the method, in comparison to 25 % - 48% in control groups. Conclusion. Even though various interceptive treatments of palatally displaced cuspids demonstrate diverse results of effectiveness, due to important difference in sample sizes and, in two RCT, lack of control group or non-randomized allocation of subjects to the control group, makes it difficult to draw a meaningful evidence-based conclusions in two of reviewed studies. Based on the published data, the most notable result with strong evidence was reported in the subjects treated with deciduous canine extraction in combination with Cervical Pull Headgear usage. It would appear that, additional application of orthodontic forces restricts physiological mesial movement of the first maxillary permanent molars. Consequently, ensuring the space maintenance and/or improvement of the upper arch permitter by preventing maxillary distal segment from anterior sagittal displacement. Therefore, preserving necessary space for palatally displaced canine to erupt. Despite demonstration of significant success rate of palatally displaced canine eruption, additional well designed RCT with proper randomization and larger sample sizes would provide more evidence-based data. |
publishDate |
2023 |
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2023-01-01T00:00:00Z 2023 2024-02-15T13:59:58Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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