Abstract
Abstract Objective The purpose of this study was to assess the current literature on the effectiveness of rapid palatal expansion (RPE) in assisting the spontaneous eruption of impacted maxillary canines. Materials and methods Four electronic databases were searched (Pubmed, Scopus, Web of Science, Embase) by applying appropriate Medical Subject Headings (MeSH). Two authors independently and systematically reviewed the literature. Randomised controlled trials (RCTs) and prospective controlled clinical trials (pCCTs) were identified and selected. The Cochrane Collaboration’s risk of bias tool and the risk of bias in non-randomised studies of interventions (ROBINS-I) were used to assess the quality of the obtained articles. Spontaneous canine eruption was used as a primary outcome. Results Three RCTs and two pCCTs met the inclusion criteria. One study was assessed at a high risk of bias in the RCT group, while the remainder were at an unclear risk of bias. Both pCCTs were classified as a moderate risk of bias based on the ROBINS-I tool. The success rate of canine eruption following RPE, with or without additional treatment, ranged from 65.7 to 85.7%, which was statistically significantly different from the control group. Conclusion RPE appears to improve the position of displaced maxillary canines and increase the likelihood of spontaneous eruption. However, there is a shortage of high-quality evidence to conclude that RPE can be an effective treatment option for impacted maxillary canines.
Highlights
Due to a long developmental and eruption pathway, a maxillary canine is a frequently ectopic and impacted tooth, second only to third molars.[1]
The impaction of a maxillary canine (IMC) affects 0.2– 2.3% of orthodontic patients[2] and the incidence of impaction is twice as high compared with the mandibular canine
The present review found that the success rate of canine eruption following rapid palatal expansion (RPE), with or without additional appliances, ranged between 65.7 and 85.7%
Summary
Due to a long developmental and eruption pathway, a maxillary canine is a frequently ectopic and impacted tooth, second only to third molars.[1] The impaction of a maxillary canine (IMC) affects 0.2– 2.3% of orthodontic patients[2] and the incidence of impaction is twice as high compared with the mandibular canine. The prevalence is twice as high in females compared with males[3] and the ratio of palatal to buccal impaction is 8 to 1.1. This condition is associated with other dental anomalies such as third molar agenesis and pegshaped maxillary lateral incisors.[4,5] The aetiology of impacted maxillary canines is controversial and considered multifactorial. Associated environmental factors include over-retained primary canines, anomalous permanent lateral incisors, disturbances in the permanent tooth eruption sequence, trauma, premature root closure, the rotation of the tooth buds, and localised pathological lesions (cysts, odontomas).
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