Predictive factors associated with adjacent teeth root resorption of palatally impacted canines in Arabian population: a cone-beam computed tomography analysis

Comparative evaluation of alveolar bone remodeling and root length changes in fixed appliances versus clear aligners: A retrospective cohort study on skeletal Class III malocclusion treatment

BACKGROUND

The retrospective study examined changes in the root length and alveolar bone surrounding maxillary incisors in patients with skeletal Class III malocclusion treated by surgical orthodontic treatment with either fixed appliances (FAs) or clear aligners (CAs).

METHODS

A total of 60 subjects were divided based on appliance type used. Cone beam computed tomography scans were taken at three stages: before treatment, after presurgical orthodontic treatment, and post-treatment for both groups. Vertical alveolar bone level and horizontal alveolar bone thickness (ABT) were measured at four heights (3, 6, and 9 mm from the cementoenamel junction, and the root apex), along with root length, at these time points.

RESULTS

Both groups showed a decrease in root length, with the CA group experiencing a significantly smaller reduction (0.4 ± 0.79 mm) compared with the FA group (0.64 ± 0.8 mm; P = 0.02). The FA group demonstrated more significant reduction in palatal ABT (P < 0.05) and greater root resorption, whereas the CA group exhibited considerable labial marginal bone resorption (P = 0.007) and a notable decrease in labiolingual inclination (P = 0.042).

CONCLUSIONS

The findings suggest that FA and CA might lead to decreased ABT and significant root resorption, with FA therapy likely resulting in more pronounced effects. Both modalities led to notable vertical bone loss, particularly, on the labial side of the maxillary incisors in the CA group during postsurgical orthodontic treatment. Preventing iatrogenic deterioration of periodontal support surrounding the incisors is crucial during presurgical and postsurgical phases.

Comprehensive Management of Mandibular Canine Transmigration: A Multidisciplinary Approach

Transmigration of mandibular canine teeth is a rare dental anomaly characterized by the tooth's aberrant migration through the alveolar bone. This deviation from the expected eruption pathway can lead to tooth impaction, root resorption, periodontal problems, and aesthetic concerns. The exact cause of transmigration is not fully understood, but it is believed to be influenced by a combination of genetic, developmental, and environmental factors. Early diagnosis and appropriate treatment are essential to prevent complications and achieve optimal functional and aesthetic outcomes. This case report presents a 19-year-old female with impacted left mandibular canine teeth. An interdisciplinary approach involving orthodontic therapy and surgical exposure to disimpact the transmigrated canine into the normal occlusal position. The treatment utilized modified orthodontic mechanics, including uprighting springs and temporary anchorage devices (TADs) to treat transmigration. This case also highlights the importance of early diagnosis and timely intervention for transmigrated canine teeth to prevent complications and achieve optimal aesthetic and functional outcomes.

Impacted maxillary canine: Assessment of prevalence, severity and location of root resorption on maxillary incisors: A retrospective CBCT study

BACKGROUND

The maxillary permanent canine is one of the most frequently impacted teeth, which often requires multidisciplinary management. A common complication of canine impaction is root resorption of the adjacent dentition. The aim of this retrospective study was to report the prevalence of root resorption of maxillary incisors adjacent to impacted maxillary canines from small volume CBCT images by trained clinicians. A secondary objective was to report the location and severity of root resorption.

MATERIAL AND METHODS

CBCT images of patients with impacted maxillary canines (unilateral and bilateral) who attended a joint orthodontic/surgical multidisciplinary clinic were screened. Descriptive statistics were used to investigate associations of patient characteristics and presence of root resorption. Generalized estimating equations (GEE) logistic regression model were used to identify predictors of root resorption.

RESULTS

In all, 148 impacted maxillary canines (122 patients) were analysed. The majority of patients were under 18 years of age (71.6%) with impacted canines present in more females (68.2%) than males (31.8%). Maxillary lateral incisors showed the highest prevalence of root resorption (38.5%). The apical region was the most common location of resorption for lateral incisors (20.9%) with a variable degree of severity evident: slight (10.1%), moderate (15.6%), and severe (12.8%). Although no significant predictors of root resorption were identified, a weak association was evident for age and root development.

CONCLUSIONS

In this cohort of patients, the roots of maxillary lateral incisors are most likely to suffer from root resorption in the presence of an impacted maxillary canine. Clinicians should consider the extent, location and severity of resorption of adjacent teeth when planning treatment decisions and mechanics in cases of impacted maxillary canines.

The Influence of Orthodontic Treatment on Periodontal Health between Challenge and Synergy: A Narrative Review

By correctly repositioning teeth, orthodontic therapy improves both the function and appearance of an occlusion. The relationship between teeth and the tissues that surround and support them significantly influences these alterations. With ever more adults seeking orthodontic care, orthodontists are increasingly seeing patients with periodontal issues. Concerns about the patient's appearance, such as uneven gingival margins or functional issues caused by inflammatory periodontal diseases, should be accounted for when designing orthodontic treatment plans. Furthermore, orthodontics may increase the chances of saving and recovering a degraded dentition in cases of severe periodontitis. Today, general dentists, dontists, and orthodontists play integrative roles that enable them to achieve the best possible results for their patients. This review will improve the results of interdisciplinary treatments and increase cooperation between dental specialists by drawing attention to the essential connection between orthodontics and periodontics in regular clinical practice.

Prevalence, etiology, clinical features and management associated with impacted and transmigrated mandibular canines: a systematic review

BACKGROUND

The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The associated etiological factors and the clinical guidelines for the management are still not clear. The aim of this systematic review was to summarize the available data to report the prevalence and identify the etiological factors, clinical features, and various treatment outcomes in patients with mandibular canine impaction and/or transmigration.

METHODS

The review protocol was registered in PROSPERO (CRD42021222566) and was conducted and reported according to the PRISMA and Cochrane Handbook / Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A computerized search of studies published up to April 30, 2023, was conducted using the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature. A manual search of the reference and citation lists of eligible articles and existing systematic reviews for any additions were also conducted. The Newcastle-Ottawa Scale quality assessment tool was used to assess the studies' quality.

RESULTS

After removing 6 duplicates, 3700 articles were identified. For the final analysis, 19 studies published between 1985 and 2023 met all the eligibility criteria and were included. A total of 7 studies presented as good and 12 studies presented as satisfactory. Patients were screened in ten studies and diagnostic records from archives were retrieved in nine studies. The total number of diagnostic records screened was 138.394, and the total number of patients from the included studies was 43.127.

CONCLUSIONS

Based on the findings from this systematic review, the prevalence of mandibular canine impaction ranged from 0.008% to 1.29% while canine transmigration from 0.12% to 0.98%. Crowding of the mandibular arch, the presence of a retained deciduous canine, and odontoma or cyst are the etiological factors more commonly associated with mandibular canine impaction and or transmigration. Surgical extraction and surgical exposure followed by orthodontic traction are the two most frequently carried out treatment modalities in the management of mandibular canine impaction and or transmigration.

Prevalence of canine impaction in the western province of Saudi Arabia: A cross-sectional survey

BACKGROUND/AIM

Canine tooth impaction could have a negative influence on the stomatognathic system and could make it difficult for clinicians to manage malocclusions. The aim of this retrospective study was to investigate the prevalence of canine impaction, which could be a cause of malocclusion, in the population in the western province of Saudi Arabia.

METHODS

A retrospective analysis of digital orthopantomograms (OPGs) of 400 patients aged 12-40 years, who are citizens of Saudi Arabia residing in the western province and who presented for treatment at the dental clinics of Batterjee Medical College, Jeddah, Saudi Arabia were included. The OPGs and dental records of these patients were reviewed for canine impaction and were categorized based on age, gender, and type of impaction.

RESULTS

The prevalence of patients that exhibited canine impaction was found to be 4%. Males had a significantly higher percentage of prevalence than females (P < 0.016), and impaction was significantly higher among patients aged below 18 years (P < 0.001). Moreover, the most commonly observed impaction was mandibular canine impaction (87.5%).

CONCLUSIONS

Prevention of malocclusion and maintenance of a normal dentition (better aesthetics and chewing) necessitates early detection of impacted canines.

Root Resorption of the Permanent Central Incisor through Ectopic Eruption of the Maxillary Canine

Although ectopic eruption of the maxillary canine has a low prevalence, a late diagnosis can have serious consequences. A careful clinical examination, assisted with radiographic examination, ensures early diagnosis, facilitates planning, and minimizes possible adverse consequences. This study reports a case of ectopic eruption of the permanent maxillary canine, with complete root resorption of the central permanent incisor, the consequences of which caused functional, aesthetic, and psychological harms to the patient. The procedures used included canine ectopic remodeling of the ectopic canine in the central incisor and orthodontic correction, which treated the anomaly and rebuilt the patient's self-esteem.

A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances

BACKGROUND

This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT).

METHODS

One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations.

RESULTS

Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively.

CONCLUSIONS

CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.