WITHDRAWN: Extraction of primary (baby) teeth for unerupted palatally displaced permanent canine teeth in children.

BACKGROUND: The permanent canine tooth in the maxillary (upper) jaw sometimes does not erupt into the mouth correctly. In about 1% to 3% of the population these teeth will be diverted into the roof of the mouth (palatally). It has been suggested that if the primary canine is removed at the right time this palatal eruption might be avoided. This is an update of a Cochrane review first published in 2009. OBJECTIVES: To evaluate the effect of extracting the primary maxillary canine on the eruption of the palatally ectopic maxillary permanent canine. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 20 April 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1946 to 20 April 2012) and EMBASE via OVID (1980 to 20 April 2012). There were no restrictions regarding language or date of publication. SELECTION CRITERIA: Trials were selected if they met the following criteria: a randomised or quasi-randomised controlled trial, involving the extraction of the deciduous maxillary canine and assessing eruption/non-eruption of the palatally displaced maxillary permanent canine. DATA COLLECTION AND ANALYSIS: Data extraction was undertaken independently by two review authors. The primary outcome was the reported prevalence of eruption or non-eruption of the ectopic permanent canine into the mouth following observation or intervention. Results were to be expressed as risk ratios for dichotomous outcomes with 95% confidence intervals and mean differences for continuous outcomes. Heterogeneity was to be investigated, including both clinical and methodological factors. Authors of trials were contacted to request unpublished data. MAIN RESULTS: Reports of two randomised controlled trials previously excluded from an earlier version of the review due to "deficiencies in reporting, insufficient data" have now been included. These two trials included approximately 128 children, with more than 150 palatally displaced canine teeth, and both were conducted by the same research group. Data presented in the trial reports are either incomplete or inconsistent. Both trials are at high risk of bias. It must be emphasised that both trials have serious deficiencies in the way they were designed, conducted, and reported, and attempts to contact the authors to obtain detailed information and clarify inconsistencies have been unsuccessful. Allocation to treatment appears to be at the level of the individual, but outcomes of successful treatment relate to included teeth and data are not reported for each treatment group. Adverse effects are not reported. Neither trial provides any evidence to guide clinical decision making. AUTHORS' CONCLUSIONS: There is currently no evidence of the effects of extraction of primary canine teeth in 10-13 year old children with one or two palatally displaced permanent canine teeth.

[Recognizing and preventing disturbances in eruption]. / Herkennen en voorkomen van eruptiestoornissen.

Disturbances in eruption and related problems are quite common in permanent dentition but rare in deciduous dentition. For the timely recognition of disturbances in eruption, knowledge of the normal development of dentition is essential. Disturbances in eruption comprise disturbances in which eruption does not occur at all, in which it is delayed or incomplete, or in which the normal direction of eruption is influenced. If identified early enough, many undesirable dental conditions can be avoided or their seriousness can be limited. A possible impacting of permanent cuspids, for example, can be avoided by extracting the deciduous cuspids at the right moment; in cases of a large overjet or the threat of a cover-bite, lip interference can be prevented.

Extraction of primary (baby) teeth for unerupted palatally displaced permanent canine teeth in children.

BACKGROUND: The permanent canine tooth in the maxillary (upper) jaw sometimes does not erupt into the mouth correctly. In about 1% to 3% of the population these teeth will be diverted into the roof of the mouth (palatally). It has been suggested that if the primary canine is removed at the right time this palatal eruption might be avoided. This is an update of a Cochrane review first published in 2009. OBJECTIVES: To evaluate the effect of extracting the primary maxillary canine on the eruption of the palatally ectopic maxillary permanent canine. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 20 April 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1946 to 20 April 2012) and EMBASE via OVID (1980 to 20 April 2012). There were no restrictions regarding language or date of publication. SELECTION CRITERIA: Trials were selected if they met the following criteria: a randomised or quasi-randomised controlled trial, involving the extraction of the deciduous maxillary canine and assessing eruption/non-eruption of the palatally displaced maxillary permanent canine. DATA COLLECTION AND ANALYSIS: Data extraction was undertaken independently by two review authors. The primary outcome was the reported prevalence of eruption or non-eruption of the ectopic permanent canine into the mouth following observation or intervention. Results were to be expressed as risk ratios for dichotomous outcomes with 95% confidence intervals and mean differences for continuous outcomes. Heterogeneity was to be investigated, including both clinical and methodological factors. Authors of trials were contacted to request unpublished data. MAIN RESULTS: Reports of two randomised controlled trials previously excluded from an earlier version of the review due to "deficiencies in reporting, insufficient data" have now been included. These two trials included approximately 128 children, with more than 150 palatally displaced canine teeth, and both were conducted by the same research group. Data presented in the trial reports are either incomplete or inconsistent. Both trials are at high risk of bias. It must be emphasised that both trials have serious deficiencies in the way they were designed, conducted, and reported, and attempts to contact the authors to obtain detailed information and clarify inconsistencies have been unsuccessful. Allocation to treatment appears to be at the level of the individual, but outcomes of successful treatment relate to included teeth and data are not reported for each treatment group. Adverse effects are not reported. Neither trial provides any evidence to guide clinical decision making. AUTHORS' CONCLUSIONS: There is currently no evidence of the effects of extraction of primary canine teeth in 10-13 year old children with one or two palatally displaced permanent canine teeth.

Extraction of primary (baby) teeth for unerupted palatally displaced permanent canine teeth in children.

BACKGROUND: The permanent canine tooth in the upper (maxillary) jaw sometimes does not erupt into the mouth correctly. In about 1% to 3% of the population these teeth will be diverted into the roof of the mouth (palatally). It has been suggested that if the deciduous canine is removed at the right time this palatal eruption might be avoided. OBJECTIVES: To evaluate the effect of extracting the primary maxillary canine on the eruption of the palatally ectopic maxillary permanent canine. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register (to April 2008); CENTRAL (The Cochrane Library 2008, Issue 3); MEDLINE (1966 to April 2008); EMBASE (1980 to April 2008). There were no language restrictions. Authors of trials were contacted for further data. SELECTION CRITERIA: Trials were selected if they met the following criteria: a randomised or quasi-randomised controlled trial, involving the extraction of the primary maxillary canine and assessing eruption/non-eruption of the palatally displaced maxillary permanent canine. DATA COLLECTION AND ANALYSIS: Seven review authors independently, in duplicate, examined the studies found in the search. The primary outcome was the reported prevalence of eruption or non-eruption of the ectopic permanent canine into the mouth following observation or intervention. Results were to be expressed as risk ratios for dichotomous outcomes with 95% confidence intervals and mean differences for continuous outcomes. Heterogeneity was to be investigated, including both clinical and methodological factors. MAIN RESULTS: The search identified 324 publications of which 295 were excluded after reviewing the abstract. Full articles were obtained for the remaining 31, of which 19 were non-English and required translation. Three reports of two randomised controlled trials were identified for possible inclusion in the review; however, the data in the publications were not presented in a form that could be usable and the authors have been contacted for further details. AUTHORS' CONCLUSIONS: There is currently no evidence to support the extraction of the deciduous maxillary canine to facilitate the eruption of the palatally ectopic maxillary permanent canine. Two randomised controlled trials were identified but unfortunately, due to deficiencies in reporting, they cannot be included in the review at the present time.

Supernumerary teeth and mental retardation: the importance of early surgical intervention.

AIM: This paper reported a rare case of hyperdontia in a child of 10 years who revealed a mixed dentition and a light mental retardation. MATERIALS AND METHODS: The therapeutic approach has been based on interdisciplinary cooperation between the pediatric dentist, orthodontist and oral surgeon. TC-Dentascan, with a panoramic and occlusal radiographs revealed the presence of two supernumerary teeth in the premaxillary region and clinical examination showed an abnormality of dentoalveolar complex. Both impacted supernumerary teeth were extracted under general anesthesia. Clinical examination revealed that they appeared two premolars in shape with fully formed crowns and partly formed roots. RESULTS: Three months after the extraction of supernumerary teeth there was a spontaneous eruption of permanent central incisors and left lateral incisor. CONCLUSION: The authors emphasized the importance of removal of supernumerary teeth to eliminate the cause of a delayed eruption of permanent teeth.

Prophylactic removal of asymptomatic third molars: a review.

Mandibular and maxillary third molars are mostly consigned to 'waste bins' in dental practices because they are terminal in developmental timing and positioning in the dental arches, and regarded as functionally non-essential. Thus, many dental practitioners do not attach significance to the presence of third molars when making therapeutic recommendations to patients about preservation of the dentition. The need for taking more a serious account of third molars is reviewed in this paper.

Reducing the incidence of unerupted palatally displaced canines by extraction of deciduous canines. The history and application of this procedure with some case reports.

The procedure of extracting the deciduous canine to reduce the incidence of the unerupted palatally displaced canine was first described in 1951, and an article solely devoted to the technique appeared in 1959. The procedure then virtually vanished until 1981. A prospective study published in 1988 created the first widespread interest in the method which now appears in major texts. Why the procedure succeeds is uncertain. In the 1950s non-resorption of the deciduous canine was thought to cause palatal deflection of its successor and therefore it appeared appropriate to extract the obstructing deciduous tooth. It has been estimated that the technique should be successful in approximately one in three of all cases in the population aged 10 to 13 years. The earlier the detection the better the prognosis, because the unerupted canine frequently moves more mesially with time. Before the procedure is attempted it is important to discuss possible outcomes with the patient. Three successfully treated cases are illustrated. The first conformed with the guidelines of having an uncrowded maxillary arch and being aged between 10 and 13 years. The second was aged 15 years 2 months at commencement. An unsuccessful surgical exposure of the permanent canines followed by extraction of the deciduous canines was carried out in the third case.