Redirection of palatally ectopic maxillary canines: Case report and proposition of an interceptive sequential guideline.

The eruptive deviation of the permanent maxillary canine must be identified early, at the beginning of the second transitional period of the mixed dentition. Acting at this moment is fundamental for its spontaneous redirection and eruption. The aim of the paper is to present a case where the extraction of the deciduous canines was the choice for redirecting the maxillary permanent canines with eruptive palatal deviation, as well as to suggest a sequence of procedures for diagnosis and choice of treatment. The success of deciduous canine extraction in redirecting the ectopic permanent canines is discussed in this case, as well as aspects that might lead to failure. Still, it highlights the importance of computed tomography for choosing conservative treatment or traction, including it in the sequential guideline for acting in these cases.

Do the various interceptive treatment modalities improve the position of palatally displaced permanent canines? A meta-analysis.

BACKGROUND: Removal of maxillary primary canines and other interceptive treatment modalities in the mixed dentition have been suggested as methods used to increase the rate of normal eruption of palatally displaced permanent canines (PDCs). However, the information on the overall effect on PDCs' position has been inconclusive. OBJECTIVE: To assess whether this practice improves the position of PDCs and to investigate the quality of the evidence. SEARCH METHODS: Unrestricted searches in 7 databases and manual searching of the reference lists in relevant studies were performed up to June 2022 (Medline via PubMed, CENTRAL, Cochrane Database of Systematic Reviews, Scopus, Web of Science, ClinicalTrials.gov, ProQuest Dissertations, and Theses Global). SELECTION CRITERIA: We looked for data on the positional changes of PDCs (mesial inclination, vertical position, canine crown cusp tip to midline) from randomized controlled trials assessing the various interceptive treatment modalities. DATA COLLECTION AND ANALYSIS: Following study retrieval and selection, relevant data were extracted, and the risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. Exploratory synthesis and meta-regression were conducted using the random effects model and the overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. RESULTS: Five studies (3 at low risk of bias) were identified, involving 238 individuals, followed for up to 18 months post-intervention with OPG (orthopantomogram) or CBCT (cone-beam computed tomography). Exploratory data synthesis showed that PDCs' position improved more in the extraction sites compared to non-extraction. Analysis of the studies at low risk confirmed the above observations (6- and 12-month). Improvements were observed in patients using headgear after extraction of primary canines compared to extraction alone, but not in patients with double extraction of primary canines and first molars. The quality of available evidence was rated at best as moderate. CONCLUSIONS: Interceptive treatment modalities in the mixed dentition may improve the position of PDCs. However, more studies are necessary in order to determine the clinical significance of the changes. REGISTRATION: PROSPERO (CRD42015029130).

Outcome of Surgical Extraction of Linguoverted Deciduous Mandibular Canine Teeth, Performed as an Interceptive Orthodontic Procedure in Puppies, on Permanent Occlusion.

Linguoversion of deciduous mandibular canine teeth can be a painful condition, interferes with the development and growth of the jaws, and potentially leads to further malocclusions affecting permanent dentition. Extraction of linguoverted deciduous mandibular canines is considered an interceptive orthodontic procedure that would allow unimpeded development of the jaws and permanent teeth. This study assessed clinical records of 124 dogs that had linguoverted deciduous mandibular canine teeth surgically extracted between October 2010 and September 2019 in a veterinary dental referral clinic. Seventy-seven cases fulfilled the study criteria. Fifty-one percent of these patients required further orthodontic treatment of the permanent occlusion and forty-nine percent demonstrated atraumatic permanent occlusion. The study found no correlation of the outcome with age at the time of surgery. The class of malocclusion (class 1 or class 2) at the time of surgery was also not associated with the outcome.

How effective is maxillary expansion as an interceptive treatment in individuals with palatally displaced canines? A systematic review and meta-analysis.

BACKGROUND: The objective was to provide a synthesis of the existing literature on the effectiveness of maxillary expansion in intercepting palatally displaced canines (PDCs). METHODS: Studies that evaluated the effectiveness of maxillary expansion in subjects with PDCs in the mixed dentition period were included. The following electronic databases were searched until November 30, 2021: MEDLINE (via PubMed), Scopus, Google Scholar, Web of Science, and Cochrane library. Grey literature search and manual search were also performed. The risk of bias was assessed using the Cochrane tool for the one randomized controlled trial (RCT) and the ROBINS-I tool for the non-RCTs. The data were extracted and meta-analysis was performed using RevMan 5.4. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to assess the certainty of evidence. RESULTS: Four studies were selected from 9,586 records, which included one RCT and three non-RCTs. The former demonstrated a high risk of bias whereas the non-RCTs showed moderate risk. The meta-analysis of three non-RCTs found no significant improvement in the alpha angle of canines after rapid maxillary expansion, with a difference of -4.26 (95% CI -11.41 to 2.89; P = 0.24). The RCT showed an increase in the eruption rate of high-risk canines with rapid maxillary expansion. Slow maxillary expansion did not demonstrate any favorable change. The level of evidence ranged from low to very low. CONCLUSIONS: There is insufficient evidence to recommend the use of maxillary expansion as a stand-alone procedure in intercepting PDCs. Additional well-conducted trials are required.

The Efficacy of a New AMCOP® Elastodontic Protocol for Orthodontic Interceptive Treatment: A Case Series and Literature Overview.

BACKGROUND: Elastodontics is a specific interceptive orthodontic treatment that uses removable elastomeric appliances. They are functional appliances that produce neuromuscular, orthopedic and dental effects. Thus, these devices are useful in the developmental age, when skeletal structures are characterized by important plasticity and adaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This work can be useful to update all orthodontists already adopting these appliances or for those who want to approach them for the first time. This study aimed to describe four cases treated with new elastomeric devices called AMCOP Bio-Activators and to provide an overview of elastodontics, its evolution, indications and limits. METHODS: A total of four clinical cases were presented after a treatment period of 16-20 months to evaluate the clinical and radiological effects of the elastodontic therapy. RESULTS: The effectiveness of Bio-Activators on clinical cases was evidenced with a significant improvement in skeletal and dentoalveolar relationship, and malocclusion correction in a limited treatment period (16-20 months). CONCLUSIONS: The Bio-Activators showed clinical effectiveness to achieve therapeutic targets according to a low impact on the patient's compliance.

Revisión de los principales manejos ortodónticos interceptivos y correctivos no quirúrgicos de la maloclusión clase III / Review of the main non-surgical interceptive and corrective orthodontic management of Class III malocclusion

La maloclusión clase III se considera un reto en la práctica de todo ortodoncista. Una de las principales dudas al respecto reside en ¿cuándo es el mejor momento para intervenir? Exis- ten dos enfoques en el manejo ortodóntico del paciente: 1) la ortodoncia interceptiva; y 2) la ortodoncia correctiva. La or- todoncia interceptiva busca la prevención del establecimiento de la malolcusión. En este grupo, se encuentra el uso de más- cara facial con disyunción maxilar y el de aparatología fija (2x4 o 2x6). Por otro lado, la intervención correctiva hace re- ferencia al camuflaje de las características que trae consigo la maloclusión clase III ya establecida; dentro de este enfoque se encuentran las extracciones de piezas, el uso de minitornillos extraalveolares y la filosofía MEAW. Se puede concluir que el adecuado manejo de la maloclusión clase III radica en el oportuno y correcto diagnóstico, que debe realizarse a través de la minuciosa inspección de las características y hallazgos intra y extraorales de los pacientes (AU)

Class III malocclusion is considered a challenge in the practice of every orthodontist. One of the main questions is: when is the best time to intervene? There are 2 approaches to the orthodontic management of the patient: 1) interceptive orthodontics, and 2) corrective orthodontics. Interceptive or- thodontics seeks to prevent the establishment of malocclusion by means of the use of a facial mask with maxillary disjunc- tion, or the use of fixed appliances (2x4 or 2x6). Corrective intervention refers to camouflaging the characteristics of a Class III malocclusion that is already established. This ap- proach uses tooth extraction, extra-alveolar mini screws or the MEAW philosophy. To conclude, proper management of Class III malocclu- sion is based on timely, correct diagnosis, which must be made through careful inspection of the characteristics and intraoral and extraoral findings in patients (AU)

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.

Interception and early treatment with rapid maxillary expansion for the impacted maxillary permanent central incisor in children: Two cases report with 5-years follow-up.

INTRODUCTION: The maxillary central incisor impaction represents a complex challenge in paediatric dentistry practice and may result in aesthetic and functional disharmony. The causes of this condition include physical barriers associated or not with a lack of space making eruption not possible, idiopathic ectopic positioning of the teeth or by trauma, non-coordination in rhizalysis and rhizogenesis between deciduous and successor or tooth shape abnormalities. The incidence of this involvement is quite rare, around 1% of the population. Opening of space through disjunction of the palatal suture is the main treatment proposed to solve this situation and, when necessary, the orthodontic traction assisted by surgery. DESCRIPTION: Were presented two cases of maxillary central incisors impaction in children treated with rapid maxillary expansion, alignment and levelling, and a follow-up after 5 years of treatment. RESULTS AND CONCLUSIONS: The challenge of these treatments were based on the early treatment in mixed dentition with expansion. The treatment of permanent maxillary central incisor impaction in children enabled excellent periodontal response and post-treatment occlusal stability.

Effectiveness of various interceptive treatments on palatally displaced canine-a systematic review.

OBJECTIVE: The aim of this systematic review was to assess whether interceptive treatment carried out in the mixed dentition period improves the position of Palatally Displaced Canines (PDC). MATERIALS AND METHODS: A systematic search was performed on various computerized databases. A hand search was also performed by reviewing the references within the examined studies and titles of the papers published over the last 30 years on various orthodontic journals. RESULTS: This systematic review analysed eight articles, of which five were Randomized Clinical Trials (RCT) and three were prospective control studies. Qualitative assessment was done for all the eight studies. The effect of interceptive measures such as extraction of primary canine, Rapid Maxillary Expansion (RME), cervical pull headgear and Transpalatal Arch (TPA) on successful eruption of Palatally Displaced Canines was analyzed. CONCLUSION: Interceptive treatment improves the position of PDC and reduces the chances of impaction. Significant changes in success rate depend on diagnosis at early mixed dentition stage. A combination of interceptive measures which includes extraction of primary canine, cervical pull headgear, TPA and RME aided in successful eruption. However, Randomized clinical trials with increased sample size, proper randomization comparing all the interceptive measures along with assessment of other factors such as patient satisfaction, pain experience and cost factor will yield more evidence based conclusions.

Rapid maxillary expansion assisted by mini-implants anchorage: A case report.

Rapid maxillary expansion (RME) is an orthopaedic treatment frequently used to correct transversal problems in the maxilla. The aim of this case report was to evaluate the transversal skeletal and dental changes in a 12-year-old male patient with maxillary atresia and bilateral posterior crossbite who had been treated with rapid maxillary expansion assisted by mini-implant anchorage. The results showed an increase of 6.2mm in the maxillary width, an increase of 6mm, 8mm and 9mm in the fossa-fossa measurements between first premolars, second premolars and first molars respectively, also there was a vestibuloversion of molars as an undesirable effect. Mini-implants, as skeletal anchorage in rapid maxillary appliances is a good alternative to achieve an increase of transverse skeletal and dental dimensions with a minimum amount of side effects.

Systematic Review and Meta-Analysis of Passive Lower Lingual Arch for Resolving Mandibular Incisor Crowding and Effects on Arch Dimension.

Purpose: This systematic review and meta-analysis assessed whether passive lower lingual arch (LLA) resolves mandibular incisor crowding and affects mandibular arch dimension. Methods: We searched PubMed, Web of Science, and Cochrane Database of Systemic Reviews for both randomized controlled trials and nonrandomized studies from 1940 to March 2018. Inclusion criteria were healthy children in mixed dentition with mandibular incisor crowding treated with LLA. Our primary outcome was the amount of mandibular incisor crowding resolved after LLA, and secondary outcomes were effects of LLA mandibular arch dimension changes versus untreated controls (UTCs). Results: From 559 screened articles, seven qualified for systematic review and meta-analyses. The average resolution of mandibular incisor crowding after LLA was 5.10 mm (P=.001) with the evidence assessed as very low quality. Arch perimeter and arch length changes were not significantly different between LLA and UTCs (P=0.20 and P=0.87, respectively). There were significant small increases of 0.79 mm in intercanine width (P<.001) and 0.69 mm in intermolar width (P=.003) with a low and a very low quality of evidence, respectively. Conclusions: Lower lingual arch was effective in resolving mandibular incisor crowding without any significant arch perimeter or arch length changes of greater than one mm.

Tratamento da mordida aberta anterior: revisão de literatura / Treatment of previous open bite: literary review

Objetivo: realizar uma revisão de literatura sobre os tipos de tratamento empregados na correção da mordida aberta anterior. Materiais e métodos: foi realizada uma busca nas bases de dados PubMed, SciELO e Google Acadêmico. Os termos inseridos na pesquisa foram: Mordida Aberta; Ortodontia Corretiva; Ortodontia; Ortodontia Interceptora; Open Bite; Orthodontics, Corrective; Orthodontics; Orthodontics, Interceptive. Revisão da Literatura: a mordida aberta anterior (MAA) é uma má oclusão dentária que pode promover alteração do perfil e da fisionomia do indivíduo, dificultando também a apreensão e o corte dos alimentos. A MAA é uma das más oclusões de maior comprometimento estético-funcional, podendo ser dentária ou esquelética. A etiologia da mordida aberta anterior é multifatorial, sendo que as principais causas são hereditariedade e causas ambientais. Esses fatores interferem no crescimento e desenvolvimento normais das estruturas faciais, modificando não somente a morfologia, mas, também, a função do sistema estomatognático. Considerações finais: conclui-se que o diagnóstico precoce e a remoção do fator etiológico são fundamentais para a evolução adequada do tratamento ortodôntico.(AU)

Objective: to perform a literature review on the types of treatment used in anterior open bite correction. Materials and methods: a search was performed in the PubMed, SciELO, and Google Scholar databases. The terms entered in the search were Mordida Aberta; Ortodontia Corretiva; Ortodontia; Ortodontia Interceptora; Open Bite; Orthodontics, Corrective; Orthodontics; Orthodontics, Interceptive. Literature Review: anterior open bite (AOB) is a dental malocclusion that may change the profile and physiognomy of individuals, making it difficult to grasp and cut food. The AOB is one of the malocclusions with the most aesthetic and functional impairments, and it may be dental or skeletal. The etiology of anterior open bite is multifactorial and the main causes are heredity and environmental causes. These factors interfere with the normal growth and development of facial structures, modifying not only the morphology but also the function of the stomatognathic system. Final considerations: it is concluded that the early diagnosis and removal of the etiological factor are essential for the proper evolution of the orthodontic treatment.(AU)

Interceptive treatment in ectodermal dysplasia using an innovative orthodontic/prosthetic modular appliance. A case report with 10- year follow-up.

AIM: The treatment of a complex case of hypohidrotic ectodermal dysplasia (HED) with severe oligodontia. CASE REPORT: A 6 years old boy with HED, was treated with an orthodontic/prosthetic modular appliance. The device is custom made and consists of two parts, upper and lower, which were partially removable and partially fixed. The patient was prepared to receive dental implants for definitive oral rehabilitation. The treatment begun with heath-cured acrylic resin removable appliance with expansion screw in the maxilla and in the mandible. Afterwards, an innovative orthodontic/prosthetic modular appliance was made in the maxilla and in the mandible, fixed with bands on the first permanent molars, with expansion screw and telescopic screw that follow and support the resin prosthetic teeth during the orthopaedic expansion. The resin prosthetic teeth are removable from the metallic fixed structure of this appliance.The patient was followed for 10 years from the beginning of treatment. CONCLUSION: The modular appliance here described and our therapeutic approach showed to be efficient and durable in the achievement of many goals in the treatment of a complex case of HED. The objectives were not only just orthodontic, but also prosthetic and psychological.

Efficiency of class III malocclusion treatment with 2-premolar extraction and molar distalization protocols.

INTRODUCTION: Different treatment protocols have been implemented for management of Class III malocclusion with aim of achieving ideal occlusal goals. The aim of current study was to compare the efficiency of Class III treatment with mandibular 2-premolar extraction and mandibular molar distalization protocol. METHODS: This retrospective cross sectional study was conducted on pre-treatment and post-treatment dental casts of 60 orthodontic patients who had Class III malocclusion and were treated with a mandibular dentition distalization and mandibular 2-premolars extraction protocol. The study was conducted at orthodontic departments of Dental Section, Faisalabad Medical University/Punjab Medical College and de'Montmorency College of Dentistry, Pakistan. The sample was classified into 2 groups. Group A consisted of 30 patients (20 females, 10 males) (mean age, 18.02years) treated with distalization protocol and Group B consisted of 30 patients (18 females, 12 males) (mean age, 18.97years) treated with mandibular 2-premolars extraction protocol. To compare the efficiency of the treatment protocol in each group, the initial and final occlusal results were assessed on dental models using PAR index while treatment efficiency was assessed using a treatment efficiency index (TX). The groups were compared with t and Mann-Whitney tests. RESULTS: There were no significant differences in the initial age, treatment time, treatment efficiency and any occlusal feature between the groups. CONCLUSION: Treatment efficiency of Class III malocclusions with mandibular 2-premolar extractions or mandibular dentition distalization protocol is similar.

[A review of the effectiveness and long-term stability of the functional appliance].

The orthopedic treatment of the orthodontics is a typical and crucial technique and method that uses functional appliances to fully work out the potentials of the jaws and muscles, and accordingly to correct the functional or mild skeletal malocclusions in pre-pubertal children and adolescents. A successful orthopedic treatment involves its short-time effectiveness and its long-term stability. For many years, however, the effectiveness of the functional appliance is controversial and the long-term stability of the functional appliance has always been overlooked. Thus, with an aim of presenting guidelines on orthopedic treatment, the effectiveness and the long-term stability of the functional appliance are discussed in this article.

Treatment of Class III malocclusion using miniscrew-anchored inverted Forsus FRD: Controlled clinical trial.

OBJECTIVES:: To evaluate the skeletal, dental, and soft tissue changes after the use of miniscrew-anchored inverted Forsus fatigue-resistant device (FRD) in treatment of Class III malocclusion. MATERIALS AND METHODS:: In this controlled clinical trial, 16 patients (9 girls and 7 boys; age 12.45 ± 0.87 years) were consecutively treated with miniscrew-anchored inverted Forsus FRD. This group was compared with a matched control group of 16 untreated patients (8 girls and 8 boys; age 11.95 ± 1.04 years). Miniscrews were inserted bilaterally between the maxillary canine and first premolar. Forsus FRD was selected and inserted in an inverted manner mesial to the mandibular headgear tube and distal to the maxillary canine bracket. RESULTS:: Class I molar and canine relationships with positive overjet were achieved in an average period of 6.4 ± 1.46 months. Maxillary forward growth showed a statistically significant increase (SNA°: 1.73 ± 0.53, P < .5), maxillary incisor proclination was statistically significant (U1 to NA°: -0.39 ± 0.33, P > .5), and the lower incisors exhibited significant retroclination (L1 to NB°: 1.65 ± 0.83, P < .5). Significant lower lip retrusion and upper lip protrusion were obvious treatment outcomes ( P < .5). CONCLUSIONS:: The use of miniscrew-anchored inverted FRD could effectively increase maxillary forward growth, but it did not prevent mesial movement of the maxillary dentition. Significant lower incisor retroclination was observed. Significant esthetic improvement of the facial profile was achieved primarily because of lower lip retrusion and upper lip protrusion.

Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial.

OBJECTIVES:: To compare different appliances for early anterior open bite (AOB) correction. MATERIALS AND METHODS:: This was a parallel, randomized clinical trial. A prospective sample of patients with AOB was recruited consecutively. Eligibility criteria included angle class I malocclusion with AOB equal to or greater than 1 mm. Participants were allocated by simple randomization to 4 groups: bonded spurs, chin cup, fixed palatal crib, and removable palatal crib. Dentoalveolar changes among the groups were assessed by blinded observers by comparing lateral cephalograms taken before (T1) and 12 months after treatment (T2; analysis of variance followed by Tukey test). Of the measurements, 30% were reassessed for reliability (intraclass correlation coefficient and Bland-Altman agreement test; α = 5%; 95% confidence interval). RESULTS:: A total of 99 patients with a mean AOB of 3.7 mm (mean age 8.4 ± 0.8 years, both genders) were recruited. Dropouts occurred in all the groups, yielding a final sample size of 81 analyzed individuals. Intergroup comparisons of differences (T2-T1) showed significant differences for the incisor positioning variables (1.1, 1-PP, 6-PP, IMPA, 1.NB and 1-GoMe). However, there was no significant difference in AOB reduction among the groups, with an average correction of 3.1 mm. CONCLUSIONS:: All of the tested devices promoted dental changes, especially in the anterior region, and contributed to AOB reduction during the study period. However, fixed palatal crib demonstrated greater impact on the positioning of the incisors.

The use of panoramic radiographs to decide when interceptive extraction is beneficial in children with palatally displaced canines based on a randomized clinical trial.

Objective: To evaluate which palatally displaced canines (PDCs) benefit from interceptive extraction of the deciduous canine, to assess possible side effects from the extraction, and to analyse other dental deviations in patients with PDCs. Design, settings, participants, and intervention: A sample of 67 patients (40 girls, mean age: 11.3 ± 1.1; 27 boys, mean age ± SD: 11.4 ± 0.9) with unilateral (45) or bilateral (22) PDCs were consecutively recruited and randomly allocated to extraction or non-extraction using block randomization. No patients dropped out after randomization or during the study. The patients were given a clinical examination and panoramic radiographs were taken at baseline and after 6 (T1) and 12 months (T2). An individual therapy plan was made for the PDCs that had not erupted at T2. Measurements were performed blindly and the outcome measures were: canine position and angulation, root development, midline shift, rotation, or movement of adjacent teeth into the extraction site, and frequency of other dental deviations. Results: Interceptive deciduous canine extraction is beneficial if the alpha angle is between 20 and 30 degrees. A PDC located in sector 4 with an alpha angle >30 degrees should have immediate surgical exposure, while canines angulated less than 20 degrees and located in sector 2 can be observed without prior interceptive extraction. Deciduous canine extraction was more beneficial in younger patients with less advanced root development. Minor side effects, such as rotation or migration of teeth into the extraction space, were observed in 15 out of 35 patients. A majority of the patients had other dental deviations than PDC in the dentition. Limitations: The results are only valid for patients with no space deficiency in the maxilla and with PDCs located in sector 2-4. Harms: No harms were detected. Conclusions: The alpha angle and sector position are good diagnostic predictors of when interceptive extraction is beneficial. Minor side effects are seen after the extraction and the majority of the patients had other dental deviations too. Registration: This trial was registered at http://www.fou.nu/is/sverige, registration number: 211141.

Effectiveness of extraction of primary canines for interceptive management of palatally displaced permanent canines: a systematic review and meta-analysis.

Background: Although extraction of primary canines in the mixed dentition has been suggested as a measure to prevent impaction of palatally displaced permanent canines (PDCs), the relevant evidence has been inconclusive. Objective: To assess the effectiveness of this practice and investigate the quality of the evidence. Search methods: Search without restrictions in 15 databases and hand searching until April 2017. Selection criteria: Randomized clinical trials comparing extraction of primary canines in the mixed dentition to no treatment. Data collection and analysis: Following study retrieval and selection, data extraction, and individual study risk of bias assessment using the Cochrane Risk of Bias Tool, the random effects method of combining treatment effects was used. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Finally 5 studies were identified involving 214 individuals, followed for up to 48 months post-intervention. Two studies were at low and the rest at high risk of bias. Although at the 12-month evaluation, extraction of the primary canine did not result in a statistically significant difference [risk ratio (RR): 1.537; 95% confidence interval (CI): 0.656-3.601, P = 0.323; 1 study, n = 67 individuals], beyond 12 months a benefit was noted (RR: 1.784; 95% CI: 1.376-2.314, P = 0.000; 5 studies, n = 214 individuals; I2 = 0%). Analysis of the studies at low risk of bias confirmed the above-mentioned result (RR: 1.713; 95% CI: 1.226-2.394, P = 0.002; 2 studies, n = 91 individuals; I2 = 0%; moderate quality evidence). No difference was observed regarding root resorption of adjacent permanent teeth (RR: 0.602; 95% CI: 0.277-1.308, P = 0.200; 1 study; n = 67 individuals; moderate quality evidence). Conclusions: Extraction of primary canines in the mixed dentition may increase the chance of subsequent successful eruption of PDC in the long term. However, better study standardization is necessary.

Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: A randomized trial.

OBJECTIVE: To evaluate and compare two treatment protocols to correct anterior dental crossbite in the mixed dentition. MATERIALS AND METHODS: Thirty children, 8-10 years of age, participated. Individuals were divided into two groups. Group 1 consisted of 15 children treated with an upper removable appliance with finger springs; group 2, 15 children treated by bonding resin-reinforced glass ionomer cement bite pads on the lower first molars. The 30 participants were evaluated before treatment (T1) and 12 months after treatment began (T2). The variables evaluated included overjet, perimeter of the maxillary arch, intercanine distances in the maxilla and mandible, SNA, SNB, ANB, and U1.NA. Data analysis included descriptive statistics, paired t-test and Student's t-test. Effect sizes and confidence intervals were also calculated. RESULTS: Group 1 showed a significant increase in overjet ( P < .001), intercanine distance in the maxilla ( P = .006), intercanine distance in the mandible ( P = .031), and U1.NA ( P = .002). Group 2 showed a significant increase in overjet ( P = .008), intercanine distance in the mandible ( P = .005), and U1.NA ( P < .001). For all the evaluated variables, no statistically significant differences were observed between the two groups. CONCLUSIONS: No significant differences were observed between the two protocols: use of a removable maxillary biteplate with finger springs and bonding of resin-reinforced glass ionomer cement bite pads on the lower first molars, for the correction of anterior crossbite in the mixed dentition.