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The treatment timing of labial inversely impacted maxillary central incisors: A prospective study
Authors:Hao Sun  Rongdang Hu  Manman Ren  Yan Lin  Xiuying Wang  Chaofan Sun  Yi Wang
Affiliation:aResident Doctor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China ; bProfessor, Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China ; cPostgraduate Student, School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China ; dAttending Physician, Department of Stomatology, People’s Hospital of Lishui, Lishui, Zhejiang, China
Abstract:Objective:To determine the timing of treatment for the labial inversely impacted maxillary central incisors.Methods:Twenty-eight patients (mean age, 8.2 years) with labial inversely impacted maxillary central incisors were divided into early-treated and later-treated groups according to their dental age. All of the patients were treated with a combination of surgery and orthodontic traction using the Guide rod appliance. Cone-beam computed tomography images were taken immediately after treatment for assessing the root morphology, root length, and alveolar bone loss. Sagittal slices were evaluated at the widest labial-lingual width of the tooth in the axial view. All variables were evaluated by Simplant 13.0 software (Materialise Dental NV, Leuven, Belgium).Results:The rank sum test indicated that the root length of two groups showed a statistically significant difference between the impacted and homonym tooth, with a shorter length in the impacted tooth (P < .05). The D-value (difference of root length between the impacted and homonym tooth) and alveolar bone loss on the labial side of the impacted incisor are significantly less in the early-treated groups when compared with the later-treated groups (P < .05). Spearman rank correlation analysis showed a statistically positive association between the treatment timing and D-value (r  =  .623, P < .05). The chi-square test for morphology of root apex indicated that the incidence of the root-apex-directed labial side is significantly higher in the later-treated groups when compared with the early-treated groups.Conclusion:The labial inversely impacted maxillary central incisors should be treated early to promote root development by achieving a better morphology of root apex, thus reducing the risk of alveolar bone loss on the labial side.
Keywords:Labial inversely impacted tooth   Central incisor   CBCT   Treatment timing
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