Abstract
Background and Objectives: The aim of this systematic review was to summarize currently available data of published articles that have investigated the post-treatment status of impacted maxillary central incisors (ICI) treated by the surgical-orthodontic approach. Materials and Methods: MEDLINE, Scopus, Cochrane Oral Health Group’s Trials Register, and ScienceDirect electronic databases were systematically searched with no publication date restrictions up to January 2021. Data assessing the status of ICI after combined surgical-orthodontic treatment and forced eruption duration were extracted, and the quality of the studies was evaluated. Results: In total, 7074 studies were identified, of which 42 articles were assessed for eligibility through full-text evaluation. Seven included studies (five retrospective studies, one randomized clinical trial, and one prospective clinical trial) met the inclusion criteria, representing 211 patients with unilaterally impacted maxillary incisors. The risk of bias ranged from moderate to high. The results show that the root length of immature ICIs increased significantly but remained shorter than that of homonym teeth at post-treatment. Periodontal parameters of treated ICIs were in a clinically acceptable range. Measurements of the alveolar bone showed a reduction of bone thickness and support. The average forced eruption duration ranged from 8.0 ± 4.5 to 14.41 ± 4.03 months. Conclusions: Based on existing evidence, it is reasonable to conclude that the surgical-orthodontic treatment affected the post-treatment status of ICI; however, the current literature is insufficient to draw concrete conclusions. Further well-conducted multi-center randomized studies with a large sample are needed to confirm this statement.
Highlights
An impacted tooth is defined as a tooth that fails to reach the occlusal plane after the normal age of eruption or when its contralateral tooth has already erupted for at least six months with a fully developed root
Previous studies reported that the impaction of maxillary central incisors occurs with a prevalence of 0.03–0.2% [1] In the retrospective study conducted by Tan et al [2], the incidence of impacted incisors was 2.0% among the Chinese orthodontic patient population, and maxillary central incisors were the most frequently affected teeth (70.6% of all impacted incisors)
Common approaches for the management of impacted maxillary permanent incisors include early interceptive measures to facilitate the eruption of displaced maxillary incisors or surgical exposure of the tooth’s crown with a subsequent orthodontic alignment of the tooth
Summary
An impacted tooth is defined as a tooth that fails to reach the occlusal plane after the normal age of eruption or when its contralateral tooth has already erupted for at least six months with a fully developed root. Supernumerary teeth, odontoma, dental trauma, the ectopic position of tooth bud, dentigerous cyst, lack of space in the arch, premature loss of deciduous teeth, cleft lip and palate, and tissue scar created as a result of early tooth extraction [2,3,4,5]. Regardless of their low incidence, impacted maxillary central incisors (ICI) constitute a huge aesthetic, developmental, functional, and psychological problem. Conclusions: Based on existing evidence, it is reasonable to conclude that the surgical-orthodontic treatment affected the posttreatment status of ICI; the current literature is insufficient to draw concrete conclusions
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