Orthodontic Procedures, With or Without Extracting Primary Canines, for the Interceptive Management of Palatally Displaced Permanent Canines: A Systematic Review

Abstract

Purpose: Although rapid maxillary expansion (RME), transpalatal arch (TPA) and cervical-pull headgear (HG) have been suggested for the interception of palatally displaced permanent canines (PDCs), existing knowledge remains inconclusive. The purpose of this study was to assess these practices in an evidence-based manner.

Methods: Randomized controlled trials (RCTs) investigating the prevalence of physiologic PDC eruption after using RME, TPA and HG, with or without the extraction of the primary canines, were searched, and the risk of bias was assessed.

Results: Data from five RCTs were included. RME, TPA and HG, with or without extracting primary canines, can significantly increase the rate of normal eruption of PDCs compared to no intervention (risk ratio [RR] = 2.5 to 4.5). In comparison to extraction, no difference was observed, except for HG combined with primary canine extraction (RR = 1.413; 95 percent confidence interval = 1.062 to 1.880).

Conclusion: RME, TPA and HG can significantly increase the rate of normal eruption of PDC compared to no intervention. However, when compared to extraction, no differences were noted, except for HG combined with primary canine extraction. (J Dent Child 2020;87(2):60-8).