Evaluation of the Accelerated Traction of Impacted Canines in Terms of Speed and Changes in the Dental Arches

The Effectiveness of Minimally-invasive Corticotomy-assisted Orthodontic Treatment of Palatally Impacted Canines in Terms of Treatment Duration and Dentoalveolar Changes Compared to the Traditional Method: A Randomized Controlled Trial.

The time required for orthodontic traction of impacted canines after surgical exposure is a particularly troubling clinical problem because it prolongs the orthodontic treatment duration. During traction process, several complications could result in alveolar bone loss, root resorption of the adjacent teeth, ankylosis, discoloration, loss or vitality and gingival recession. Accordingly, and due to the lack of studies concerned with accelerating the traction movement of the impacted canines, we conducted this study to evaluate the effectiveness of some surgical interventions (corticotomy and Piezocision) in increasing the rate of orthodontic traction movement. We also aimed to evaluate dentoalveolar changes associated with the use of such accelerating procedures compared with the conventional traction method.

Adult patients with unilateral palatally impacted canines will be included in this study. One of patient groups will be treated using fixed orthodontic appliances in combination with some accelerated surgical interventions, while the second patient group will be treated using the traditional treatment method. The velocity of traction movement will be assessed in the two groups. The differences between the two groups in terms of the total treatment duration and the traction duration will be evaluated.

Dentoalveolar changes associated with the use of such accelerating procedures will be assessed by several variables studied on cone-beam computed tomography (CBCT) images. In this study, two groups are going to be evaluated: (1) patients treated in the traditional manner, (2) patients will undergo corticotomy-assisted traction of the impacted canines.

Inclusion Criteria:

1. Patients aged 18 to 28.
2. Unilateral palatally or mid-alveolar upper impacted canine.
3. The impacted canine crown not exceeding the middle of the lateral incisor root.
4. Absence of root resorption of the lateral incisors.
5. No contact between the canine crown and the lateral incisor root.
6. Individuals not previously receiving orthodontic treatment.
7. No use of any medications that may affect the orthodontic movement.

Exclusion Criteria:

1. Bilateral or buccal canine impaction cases.
2. More than 45-degree angle between the canine's longitudinal axis and the vertical facial plane.
3. Any medical condition that prevents oral surgery.
4. Oral structural abnormality that is inherited or congenital.