Prediction of maxillary canine impaction based on panoramic radiographs

Short-Term Impact of Slow Maxillary Expansion on Labial Ectopic Canine Eruption Pathway in Children: A Retrospective Study

Objectives: This retrospective study evaluated the short-term effects of removable slow maxillary expansion (SME) on eruption patterns of labially ectopic canines in a Chinese pediatric population, comparing treated patients with untreated controls. Methods: Seventy-six patients (mean age 8.38 ± 0.88 years) underwent SME treatment for 11.04 ± 4.44 months. Canine positions were categorized as labial ectopic (TE: n = 40) or normally positioned (TN: n = 112). The TE group was stratified vertically: superior (TES; n = 15, canines above lateral incisors' roots or adjacent to unerupted incisors) and inferior (TEI; n = 25, canines adjacent to erupted lateral incisors' roots). Untreated controls (n = 58; mean age 8.46 ± 0.78 years) included labial ectopic (CE group; n = 32) and normal canines (CN group; n = 84), with CE further divided vertically into CES (n = 24) and CEI (n = 8). Panoramic radiographs at baseline (T0) and follow-up (T1) evaluated sector distribution, midline proximity (3c-ML: canine cusp to midline distance), vertical position (3c-OP: cusp to occlusal plane distance), and angular (3^ML: canine-midline angle). Results: SME significantly improved midline proximity (3c-ML increased) while reducing vertical height (3c-OP decreased) and angulation (3^ML reduced) in the TE group. Notably, TE patients revealed a significantly greater increase in 3c-ML compared to CE. Subgroup analysis showed that TEI canines exhibited significant improvements in all three parameters (3c-OP, 3c-ML, and 3^ML), whereas TES canines displayed minimal changes. The shifts in sector distribution were similar between the treatment and control groups. Conclusions: SME demonstrated short-term efficacy in guiding labially ectopic canines toward more favorable eruption trajectories, particularly when erupted beyond the roots of the lateral incisor. The observed positional improvements underscore SME's potential to optimize eruption outcomes during early orthodontic intervention.

Analysis of the Relationship Between Unilateral Posterior Crossbite and Alterations in the Eruptive Trajectory of Maxillary Canines, the Occlusal Plane, and the Inclination of the Labial Commissure

OBJECTIVES

The aim was to establish whether there is a relationship between the presence of unilateral posterior crossbite (u-PCB) and the mesio-distal inclination of permanent upper canines, the angulation of the occlusal plane, or the labial commissure inclination in children.

METHODS

A cross-sectional association study was conducted. Panoramic radiography was used to measure the inclination of the canines and the occlusal plane, and frontal rest photography was used to measure the inclination of the labial commissure. The measurements were performed with tpsDig264 software version 2.25, 2016, Ecology & Evolution, SUNY), and the data obtained were analyzed with SPSS 22.0 software, using ANOVA and Kruskal-Wallis tests for the statistical analysis.

RESULTS

A total of 106 patients with u-PCB and 41 patients in the control group were studied. No statistically significant differences were observed in the inclination of the right and left canines in patients with u-PCB compared to patients in the control group. There is a relationship between the presence of u-PCB and the inclination of the occlusal plane. No statistically significant differences were observed in the inclination of the labial commissure in patients with u-PCB compared to patients in the control group.

CONCLUSIONS

There is no relationship between the presence of u-PCB and the alteration in the eruptive trajectory of the permanent upper canines or in the inclination of the labial commissure. However, a relationship between the presence of u-PCB and altered occlusal plane inclination was found.

Prediction of the success of orthodontic treatment of impacted maxillary canines using panoramic radiography parameters: a retrospective cross-sectional study

BACKGROUND

This retrospective study aimed to investigate the relationships between the radiographic features of impacted maxillary canines (IMCs) and traction duration and the factors affecting treatment success.

METHODS

Pre-treatment panoramic radiographs and patient records of 121 consecutive patients with IMCs were analyzed. The measurements included the angle of the IMC with the midline (α-angle), the horizontal position of the IMC relative to the adjacent teeth (S-Sector), the distance from the IMC to the occlusal plane (d-distance), the apex position of the IMC (A), and the vertical height of the IMC relative to the adjacent lateral tooth (V). The measurements were repeated 1 week later. The intraclass correlation coefficient was used to evaluate the relationship between two measurements. Binary logistic regression was performed to determine the factors affecting treatment success. Linear regression was conducted to determine the relationships between traction duration and other parameters. Receiver operating characteristic (ROC) curve analysis was performed to determine the α-angle and the d-distance cutoff values for treatment success. The significance level was set at p < 0.05.

RESULTS

The buccally IMCs were mostly located in sectors 1-2, whereas the palatally IMCs were mostly located in sectors 3-4-5. The effects of the parameters on the treatment success were significant according to the logistic regression of age (p = 0.003), d-distance (p = 0.002), and α-angle (p = 0.001). Linear regression analysis revealed that traction duration was statistically significant (p < 0.001).

CONCLUSION

According to the results of this retrospective study, the α-angle, d-distance, and sector can be used to predict the buccopalatal position of the IMC. The patient's age, d-distance, and α-angle affected the treatment success. The patient's age, d-distance, and the sector of the impacted canine affected the traction duration.

CLINICAL TRIAL NUMBER

Not applicable.

Possible link between the preferential unilateral chewing side and eruptive guidance of the maxillary canine germ : Cross-sectional study on panoramic radiographs

AIM

To determine whether unilateral preferent chewing (UPC) affects the position and angulation of the permanent maxillary canine germ on the preferred side.

MATERIALS AND METHODS

In a retrospective cross-sectional study, medical records from children 7.91(± 0.8) years old with unilateral preferred chewing side and unilateral posterior crossbite were selected. The position of the maxillary canines was analysed by measuring the following angles and distances: the angles formed between the canine axis and the midline (PS; potential impact range > 15°), and that between the canine axis and the bicondylar line (W; potential impact range < 75°). In addition, the canine's position with respect to the lateral incisor (EK; potential impact range > II) and the distance between the canine cusp and the occlusal plane (CCOP potential impact range > 10 mm) were measured.

RESULTS

The final sample consisted of 106 radiographs; thus, a total of 212 maxillary canines were analysed. Tooth angulation on the preferred chewing side was higher for the angle PS with an average angle of 13.88° (± 7.56) and its position was more frequently found in sector II (49.1%), according to the EK analysis, compared to its contralateral that had an average of 11.75° (± 10.13) for the PS angle and a frequency of 67% in the sector I (p < 0.05 in both analyses). The data obtained for the angle W resulted in an average of 76.12° (± 9.09), while on the contralateral side it was 77.16° (± 12.56; p = 0.012). Lastly, according to the CCOP analysis, the preferred chewing side measured on average 15.3 mm (± 2.4), while on the nonpreferred side it was 15.19 mm (± 2.43; p = 0.143).

CONCLUSIONS

Based on this research, UPC seems to have a certain unfavourable influence on canine position and angulation. Thus, this is another factor to consider in decision-making regarding early treatment of this development disorder.

Two-Dimensional Radiographic Diagnosis of Maxillary Canine Impactions

Background: The primary aim of this study was to evaluate, using conventional radiographic imaging, the height, angulation, and mesiodistal position of impacted maxillary canines to determine if these variables are significantly associated with the palatal or buccal positioning of the tooth. Methods: A retrospective analysis was conducted on all patients diagnosed and treated for at least one impacted maxillary canine over a 4-year period in the Principality of Asturias. The final sample included 159 impacted canines. The variables analyzed were age, gender, associated pathology, location, angulation, height, mesiodistal position, buccopalatal position, and treatment method. Follow-up periods ranged from 12 to 50 months. Results: The mean age of the patients was 21 years (range 10-41 years), with most cases occurring in patients aged 14 to 30 years. Females accounted for 66.1% of the sample, with a female-to-male ratio of 1.95:1. The type of treatment (extraction/traction, surgical-orthodontic approach) was significantly associated with patient age. Additionally, the proximity of the impacted canine crown to the palatal or buccal cortices was significantly related to the treatment choice. However, no significant relationship was observed between the palatal/buccal position of the canine crown and its height or angulation. Conclusions: In the present work, the upper canines included by the palatal did not have a greater height or angulation than the canines included by the vestibule.

Comparisons of Two Different Treatment Methods for Impacted Maxillary Canines: A Retrospective Study

Background: The impaction of the maxillary canine is a common occurrence, and orthodontists must be prepared to manage it. The purpose of this article is to present a study of the efficacy of a double-wire orthodontic appliance compared to a control group in the alignment of impacted maxillary canines in the dental arch. Methods: To diagnose an impacted maxillary canine, a panoramic radiograph was taken and a detailed analysis was performed by the same orthodontist. This article presents the results of 28 impacted maxillary canines with inclusion criteria of A2 (tooth angulation to the midline 16°-45°), V1 (vertical height of the tooth crown above the cementoenamel junction but less than half the length of the root of the maxillary lateral incisor), and O3 (medial position of the canine crown of more than half but less than the entire root width of the lateral incisor) positions in 21 patients (7 males and 14 females) with a mean age of 14.02 years (SD = 1.61) who were treated by the same orthodontist for impacted maxillary canines using a fixed double-wire orthodontic appliance. The analyzed data were compared with the control group (treated with a fixed orthodontic appliance and active ligature), which was matched for pretreatment age and the A2, V1, and O3 positions of the impacted maxillary canine. Results: With both methods, the impacted maxillary canines were aligned and guided into a correct position in the dental arch, but the mean active orthodontic traction of 31 ± 4.2 weeks in the SG was statistically significantly shorter (p < 0.05) in comparison to 37 ± 6.3 weeks in the CG, and the number of visits was statistically significantly (p < 0.05) fewer in the SG (5 ± 2) than in the CG (11 ± 5). Conclusions: The findings of this study are important to the field of orthodontics and show that the alignment of impacted maxillary canines with A2, V1, and O3 positions can be achieved with both methods, but with the double-wire appliance, the treatment time was shorter and the number of visits was statistically significantly fewer. The results of this study suggest that this approach may be more efficient and cost-effective compared to conventional methods.

An artificial intelligence study: automatic description of anatomic landmarks on panoramic radiographs in the pediatric population

BACKGROUND

Panoramic radiographs, in which anatomic landmarks can be observed, are used to detect cases closely related to pediatric dentistry. The purpose of the study is to investigate the success and reliability of the detection of maxillary and mandibular anatomic structures observed on panoramic radiographs in children using artificial intelligence.

METHODS

A total of 981 mixed images of pediatric patients for 9 different pediatric anatomic landmarks including maxillary sinus, orbita, mandibular canal, mental foramen, foramen mandible, incisura mandible, articular eminence, condylar and coronoid processes were labelled, the training was carried out using 2D convolutional neural networks (CNN) architectures, by giving 500 training epochs and Pytorch-implemented YOLO-v5 models were produced. The success rate of the AI model prediction was tested on a 10% test data set.

RESULTS

A total of 14,804 labels including maxillary sinus (1922), orbita (1944), mandibular canal (1879), mental foramen (884), foramen mandible (1885), incisura mandible (1922), articular eminence (1645), condylar (1733) and coronoid (990) processes were made. The most successful F1 Scores were obtained from orbita (1), incisura mandible (0.99), maxillary sinus (0.98), and mandibular canal (0.97). The best sensitivity values were obtained from orbita, maxillary sinus, mandibular canal, incisura mandible, and condylar process. The worst sensitivity values were obtained from mental foramen (0.92) and articular eminence (0.92).

CONCLUSIONS

The regular and standardized labelling, the relatively larger areas, and the success of the YOLO-v5 algorithm contributed to obtaining these successful results. Automatic segmentation of these structures will save time for physicians in clinical diagnosis and will increase the visibility of pathologies related to structures and the awareness of physicians.

Early prevention of maxillary canine impaction: a randomized clinical trial

OBJECTIVES

To investigate the effect of three interceptive measures (slow maxillary expansion (SME) with removable plates (1), extraction of both upper deciduous canines (DC) (2) and no intervention (3)) on maxillary canine (MC) position in patients with early mixed dentition (EMD) and lack of upper arch space. These three groups were additionally compared to a control group (4) with adequate upper arch space.

NULL HYPOTHESIS

None of the studied strategies outperforms the others regarding improvement of MC position.

TRIAL DESIGN

Four-arm parallel group prospective randomized controlled trial.

PARTICIPANTS

Patients in EMD with at least one impacted MC, non-resorbed DC, and no crossbite.

INTERVENTIONS

Patients with a lack of space were randomly distributed to protocols (1), (2), and (3).

PRIMARY OBJECTIVE

To assess the change in MC position after 18 months follow up.

SECONDARY OBJECTIVES

To assess canine eruption and need for orthodontic intervention within 18-60 month follow up.

OUTCOME ASSESSMENT

Five variables defined canine position: sector, canine-to-midline angle, canine-to-first-premolar angle, canine-cusp-to-midline distance, and canine-cusp-to-occlusal-plane distance on two panoramic radiographs at 0 (T1) and 18 months (T2). Mean differences between groups were compared with linear mixed models, corrected for age and sex.

RANDOMIZATION

The patient allocation sequence was generated by an electronic randomization list.

BLINDING

The operator taking the measurements was blinded to the groups.

RESULTS

Seventy-six patients were included (142 canines, mean age 9.2 years, 60.5 per cent male, mean follow up 1.9 years), 19, 17, 14, and 26 patients in groups 1-4, respectively. In absence of dental crossbite in patients with lack of space and impacted MC, SME improved the canine sector (P = 0.040), compared to no intervention (P = 0.028). Canine-to-midline angle and canine-to-occlusal-plane distance significantly decreased in all groups at T2. Extraction improved the canine-to-first-premolar angle at T2 more than other strategies in EMD (P = 0.015-0.000).

CONCLUSIONS

Early SME improves the canine sector and reduces the need for major orthodontic intervention in the long term. Taking a first panoramic radiograph in EMD allows timely intervention in case of MC impaction.

TRIAL REGISTRATION NUMBER

NCT05629312 (Clinical Trials.org). Trial status: follow up ongoing.

Three-Dimensional Measurements of the Palate and Dental Arch Perimeter as Predictors for Maxillary Palatal Canine Impaction-A Cone-Beam Computed Tomography Image Analysis

(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal dimensions, and maxillary arch perimeter using digital measurements and determine the factors that could be used as predictors for maxillary palatal canine impaction. (2) Method: A cross-sectional study was conducted on cone-beam computed tomography images of orthodontic patients aged 15 to 25. Palatal dimensions and maxillary arch perimeter were digitally measured using Materialize Interactive Medical Image Control System. (3) Results: A significant difference was found between the case and the study groups regarding palatal depth, length, and arch perimeter, except for the palatal width. A weak correlation was reported in palatal depth and length with canine impaction, whereas the correlation was moderate concerning the arch perimeter. They can be used as predictors for palatal canine impaction. (4) Conclusion: Palatal dimensions and dental arch perimeter affect maxillary palatal canine impaction. Deficient arch perimeter, palatal depth, and length could be helpful in the prediction of maxillary palatal canine impaction.

Radiographical characteristics and traction duration of impacted maxillary canine requiring surgical exposure and orthodontic traction: a cross-sectional study

This cross-sectional study aimed to classify the radiographical characteristics of impacted maxillary canines that were surgically exposed following orthodontic traction and to find out which factor is most closely related to traction duration. This study enrolled 74 patients with 87 maxillary canines. Cone-beam computed tomography images, panoramic radiographs, and medical records were analyzed. Cystic-appearing lesion and resorption of adjacent roots were observed in 26.4% and 23.0% of cases, respectively. Impacted maxillary canines were mostly distributed in the lateral incisor area. The mean (± standard deviation) traction duration for the 47 teeth that met the study criteria was 13.9 (± 8.9) months. Impacted maxillary canines treated with surgical exposure and orthodontic traction showed increasing possibilities of palatal impaction and resorption of the adjacent root as they were located mesially (p < 0.05). The distance from the occlusal plane to the impacted maxillary canine showed the strongest positive correlation with traction duration (r = 0.519, p < 0.01). When establishing treatment plans for patients with impacted maxillary canines, distance from the occlusal plane to the impacted canines, rather than the angle, should be considered in predicting the duration of treatment.

Risk Prediction of Maxillary Canine Impaction among 9-10-Year-Old Malaysian Children: A Radiographic Study

BACKGROUND

Early diagnosis and interceptive treatment of the maxillary canine impaction is crucial as it reduces treatment complexity and decreases complications and adverse outcomes. Aim and Objectives. To determine the mean maxillary canine position among 9-10-year-old children and predict the risk of impaction of the maxillary canines. Methodology. Panoramic radiographs (PANs) of 289 healthy children aged between 9 and 10 years were observed where the average position of maxillary canines was related to the lateral incisor, sector locations, and angulations to the bicondylar line were traced. The average position was obtained by using descriptive statistics. One sample Wilcoxon signed-rank test is done to predict the risk of canine impaction by comparing the data obtained to the average position from prior studies.

RESULTS

A total of 289 PANs (126 males and 163 females) were utilized for the analysis. The findings showed that the average position of the maxillary canines in our population was statistically different from the average position of nonimpacted canines in previous studies. However, on average, more than 85% of canines in our population were still located within the safe range of satisfactory position, with females showing slight predominance outside of the acceptable range. The mean scores of the angles between the right canine and lateral incisor were significantly higher among females than males (p = 0.001). Similarly, females had a significantly higher mean angle of the left canine than males (p < 0.001). In regard to the angles between the bicondylar line and permanent maxillary canine, the mean scores were not significantly different (p > 0.05) on both the left and right side.

CONCLUSION

There is a low risk of impaction of maxillary canines in the Malaysian population. However, more retrospective studies using more radiographic and clinical indicators need to be done to confirm the risk of impaction further.

Prediction methods of maxillary canine impaction: a systematic review

OBJECTIVE

To describe and assess the available evidence of prediction methods of maxillary canine impaction (MCI).

MATERIAL AND METHODS

A systematic search was conducted through PubMed, Cochrane Library, Embase, EBSCOhost, Scopus, ScienceDirect, Bireme and Scielo until December 2020. This systematic review was conducted according to the PRISMA statement. The methodology of the selected studies was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2).

RESULTS

A total of 2391 articles were identified in the first approach and after a 2-phase selection, 11 studies were included in qualitative analysis. Prediction methods were constructed using equation-based models, geometric measurements and computational methods from clinical and imaging data to predict palatal/buccal MCI. The quality of evidence was low to moderate due to the presence of risk of bias in most of the studies included. Three cohort studies with the best methodological quality proposed prediction models based on geometric measurements, canine position and facial growth pattern that would allow predicting MCI from CBCT, lateral and panoramic radiographs.

CONCLUSIONS

The evidence is limited and most of the studies present a low methodological quality. However, it is possible to suggest that some prediction methods based on the position of the canine and facial growth pattern could predict palatal/buccal MCI in mixed dentition. Cohort studies with better methodological quality and long-term follow-up are needed to better validate a prediction model.

Misdiagnosis and Mismanagement of an Infectious Impacted Canine: A Case Presentation

: Tooth impaction is defined as a partial or complete eruption of a tooth regarding the eruption time. Hereby, we present an infectious canine in a 38-year-old man that primarily presented with chest pain and dyspnea. After two days, he demonstrated a painful swelling and erythema of the face, severe perspiration, nasal congestion, and pleural effusion. The patient was diagnosed with acute bronchitis, mucormycosis, and nasal septum abscess, leading to unnecessary antibiotic therapy and lack of treatment response. After oral and maxillofacial surgery consultation, cone-beam computed tomography (CBCT) revealed an impacted and infectious canine that was surgically extracted. Due to lack of desired response to treatment, he underwent CBCT after oral and maxillofacial surgery consultation. An impacted and infectious canine was detected, which was surgically extracted. Three days later, his symptoms significantly improved, and he was discharged with a stable general condition.

Uncovering and Autonomous Eruption of Palatally Impacted Canines-A Case Report

The impaction of permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment. This case report describes a new orthodontic-surgical approach through the use of CO₂ laser, for the exposure of the palatally impacted canines. A 13-year-old female referred to our observation to make an orthodontic examination because of the maxillary primary canines’ persistence in upper arch. Orthopanoramic X-ray showed impaction of both permanent maxillary canines. The family history revealed that the patient’s mother had the same orthodontic problem. Cone Beam Computer Tomography (CBCT) was requested to plan the surgical-orthodontic treatment. Surgical exposure of the impacted canines was performed using a CO₂ laser and subsequent periodontal pack application. No orthodontic devices were applied for impacted teeth traction on dental arch. Canines’ movement was monitored at 1, 8 and 16 weeks post-surgery with photo and intraoral scanner CS3500 (CS3500^®, Carestream Health, Atlanta, GA, USA). When canine crowns were completely erupted on palatal side, the alignment in the arch with indirect bonding technique was performed. Complete disimpaction of canine crowns was obtained in only four months. As reported in the literature, this case confirms that impacted canines’ exposure to CO₂ laser has advantages if compared with traditional surgery: no bleeding during and after the procedure, decontaminant effect on the surgical area, no suture, and a fast spontaneous eruption. Conclusions: The pre-orthodontic uncovering and autonomous eruption of palatally impacted maxillary canines provides simplified, predictable, and more aesthetic outcomes. Furthermore, a significant positive factor is that there is no need to carry out the orthodontic traction of the impacted element, undoubtedly better compliance by the patient during the next alignment phase with the fix orthodontic appliance.

Management of maxillary impacted canines: A prospective study of orthodontists' preferences

•

Children should be examined by the age of eight or nine years to assess for maxillary canine displacement and possible impaction.

•

Maxillary impacted canines are best approached and managed through interdisciplinary approach involving a pediatric dentist, orthodontist, oral surgeon, and periodontist.

•

The pediatric dentist can be the first specialist for early diagnosis and management of maxillary impacted canines, which can be achieved by facilitating the maxillary canine’s eruption and guiding it to its proposed location in the dental arch.

Background

Maxillary canines are considered the most commonly impacted teeth, after the third molars. Orthodontists have different preferences on how to approach maxillary impacted canines (MIC). The objective of this article was to investigate orthodontists’ approach to managing MIC.

Material and methods

A cross-sectional study comprising a comprehensive survey with 22 questions was sent to practicing orthodontists. This study explored the preferred diagnostic measures, surgical techniques, materials, and mechanics utilized to manage MIC;104 responses were returned.

Results

Palatal impaction was reported to be encountered more often than labial impaction by 60% of the respondents. In 62% of the respondents, an oral and maxillofacial surgeon was the specialist preferred to perform the surgical exposure. In 66%, the choice of required surgical techniques was reported as a joint decision between orthodontists and other specialists who perform the surgery. Cone-beam computed tomography (CBCT) was reported to be the diagnostic x-ray of choice. The gold button with a chain was the preferred bonded attachment in 86% of cases. Less than half of the respondents bonded the attachments themselves during surgical exposure. A clear plastic retainer was the preferred retainer in 61% of the respondents, and 43% of the respondents tended to use a closed exposure technique. Coe-pak^TM was the preferred surgical pack for orthodontists who prefer an open exposure technique. Piggyback (double wire) was the preferable mechanic to move a palatally impacted canine.

Conclusion

Our findings indicate that there are variations among orthodontists on how to manage MICs in terms of diagnostic methods, surgical management, materials, and mechanics.

Variables to predict spontaneous eruption of palatally displaced permanent canine after interceptive extraction of primary canine: A systematic review and meta-analysis

OBJECTIVE

To evaluate the effectiveness of different diagnostic variables measured on panoramic radiographs (PAN) to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition.

MATERIALS AND METHODS

Digital databases (MEDLINE, CENTRAL (Cochrane), Scopus, clinicaltrials.gov, ISRCTN registry) and hand searches were performed up to March 2020. Both randomized and non-randomized controlled trials were considered for the review. Study selection, data extraction, risk of bias assessment (RoB2.0 and ROBINS-I), and the certainty of evidence evaluation (GRADE) were performed according to Cochrane Handbook for Systematic Reviews of Interventions. The random-effects method for quantitative synthesis of dichotomous as well as continuous data was used.

RESULTS

Out of 767 retrieved records, 4 controlled trials fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk of bias except one. Overall certainty was strong to moderate. PDCs in distal sectors (RR: 1.621; 95%CI: 1.259 to 2.086; P<0.001) and alpha-angle <30° (SMD: -1.350; 95%CI: 1.924 to -0.776; P<0.001) were significantly benefited from interceptive extraction. However, Vertical distance of PDC cusp tip from occlusal plane had statistically insignificant (p: 0.855) roll on eruption prediction.

CONCLUSION

Interceptive extraction at a younger age, initial horizontal localization (sector position), and alpha-angle (initial mesial inclination) are the most important variables predicting the spontaneous eruption of palatally displaced canines. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well-designed clinical trials are recommended to strengthen the evidence.