Effect of Interceptive Strategies on the Clinical Outcome of Maxillary Impacted Canines

Not Applicable

Completed

Interventions: Procedure: Extraction of deciduous upper canines
Procedure: Maxillary expansion

Brief Summary: This study aims to investigate the effect of 3 randomly applied interceptive measures (slow maxillary expansion, extraction of deciduous canines and no intervention) on maxillary canine impaction in patients with early mixed dentition and lack of space in the dental arch. Additionally, these groups are compared with a control group with adequate space. Patients with at least one impacted maxillary canine, presence of deciduous canines and absence of crossbite were included. The canine position is assessed by measuring five variables (sector of the canine cusp, canine to midline angle, canine to first premolar angle, canine cusp to midline distance, and canine cusp to maxillary plane distance) on 2 panoramic radiographs at 0 (T1) and 18 months (T2).

Detailed Description: The detailed information regarding methodology has been entered in following sections

Recruitment & Eligibility

Inclusion Criteria

All patients presenting at the intake consultation of the Department of Orthodontics of University Hospitals Leuven, Belgium from September 2016, with at least one maxillary permanent canine impaction are invited to participate. Canine impaction is diagnosed based on a panoramic radiograph, taken for standard evaluation of dental development and associated pathology. A maxillary canine is considered to be impacted when the canine to midline angle was ≥15° (Alqerban et al. 2014; Warford et al. 2003). Only impacted maxillary canines with incomplete root formation and with persisting deciduous canines are included.

Exclusion Criteria

presence of uni- or bilateral posterior dental crossbite,
upper permanent canines showing root malformation, ankylosis or fully erupted,
evidence of root resorption of adjacent teeth, previous orthodontic treatment,
craniofacial syndromes,
systemic disease that would impede orthodontic treatment/surgery and recent exposure to radiotherapy.
large eruption follicles seen on the permanent canines

Arm && Interventions

Group	Intervention	Description
Extraction of deciduous canines	Extraction of deciduous upper canines	All included patients (in all arms) present (at least one) maxillary canine impaction. Patients in this arm present also lack of space in the upper jaw and are treated with extraction of deciduous canines
Maxillary expansion	Maxillary expansion	All included patients (in all arms) present (at least one) maxillary canine impaction. Patients in this arm present also lack of space in the upper jaw and are treated with maxillary expansion

Primary Outcome Measures

Name	Time	Method
Number of Definitive Upper Canines That Erupt Spontaneously up to 18 Months of Follow up	18 months	Number of definitive upper canines that erupt spontaneously up to 18 months of follow up.
Number of Definitive Upper Canines That Erupt Spontaneously After 18 Months of Follow up	After the first 18 months of follow up	Number of definitive upper canines that erupt spontaneously after 18 months of follow up..

Secondary Outcome Measures

Name	Time	Method
Sector Where the Canine is Located	18 months	The sector is the position where the canine overlaps with adjacent teeth in a panoramic radiograph. The distance between the dental midline and the premolars is divided in 5 equally large spaces (units or categories 0 to 4) defined as follows: 0 = normal position (the cusp of the definitive canine is at the primary canine), 1 = distal to the long axis of the lateral incisor, 2 = mesial to the long axis of the lateral incisor, 3 = distal to the long axis of the central incisor, or 4 = mesial to the long axis of the central incisor This outcome measurement refers to the change in the Sector category where the canine is located, measured on a panoramic RX
Angulation of the Canine Towards the Dental Midline	18 months	Change in the Angulation of the canine towards the dental midline, measured on a panoramic RX
Angulation of the Canine Towards the First Premolar	18 months	Change in the Angulation of the canine towards the first premolar
Distance Between the Canine Cusp and the Midline	18 months	Change in the Distance between the canine cusp and the midline
Distance Between the Canine Cusp and the Occlusal Plane	18 months	Chenge in the Distance between the canine cusp and the occlusal plane, measured on a
Need for Further Minor and/or Major Orthodontic Intervention	18 months after baseline	Need for further minor and/or major orthodontic interventions