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The efficacy of rapid palatal expansion on the eruption of impacted maxillary canine: a systematic review Cover

The efficacy of rapid palatal expansion on the eruption of impacted maxillary canine: a systematic review

Open Access
|Oct 2021

Figures & Tables

Figure 1.

Flow diagram of the studies retrieved through the selection process.
Flow diagram of the studies retrieved through the selection process.

The electronic databases searched, the search strategies used, and the corresponding results

Electronic databasesSearch strategy usedExtend of searchHits
Pubmed searched via PubMed on 8th April 2021 http://www.ncbi.nlm.nih.gov/pubmed/ (((canine OR canines)) AND (impaction OR embedded OR displaced OR impacted OR displacement)) AND (RPE OR rapid palatal expansion OR RME OR rapid maxillary expansion OR maxillary expansion OR palatal expansion)All fields90
Web of Science on 8th April 2021 https://webofknowledge.com/ (canine OR canines) AND ALL FIELDS: (impaction OR embedded OR displaced OR impacted OR displacement) AND ALL FIELDS: (RPE OR rapid palatal expansion OR RME OR rapid maxillary expansion OR maxillary expansion OR palatal expansion)All fields64
Scopus on 8th April 2021 http://www.scopus.com/ (TITLE-ABS-KEY (canine OR canines) AND TITLE-ABS-KEY (impaction OR embedded OR displaced OR impacted OR displacement)AND TITLE-ABS-KEY (rpe OR rapid AND palatal AND expansion OR rme OR rapid AND maxillary AND expansion OR maxillary AND expansion OR palatal AND expansion))All fields21
EMBASE on 8th April 2021 https://www.embase.com (canine OR canines OR cuspid) AND (impaction OR impacted OR displaced OR displacement) AND (rpe OR rme OR ‘rapid maxillary expansion’ OR ‘rapid palatal expansion’)All fields21

Summary of characteristics of the included studies_

AuthorStudy designCriteria for impacted canineInterventionParticipant gender and ageMethod/measurementCriteria for successful treatmentFollow-up duration and dropoutOutcome
Armi (2011)RCTPDCs: Intraosseous palatal position of maxillary permanent canine diagnosed from panoramic radiographs or periapical radiographs3 groups 1. HG group 2. RPE/HG group 3. CGTotal 60 subjects 1. HG group: 17 subjects (with 25 PDCs) M/F = 9/8, 11.9 years 2. RPE/HG group: 21 subjects (with 30 PDCs) M/F = 9/12, 11.1 years 3. CG, 22 subjects (with 26 PDCs) M/F = 9/13,11.6 yearsPanoramic radiographs, lateral cephalogram and measurement on dental castFull eruption of the tooth which permitting bracket positioning for final arch alignmentAll groups: 18 months and 4 dropoutsSuccessful eruption of the permanent canine were 82.3% in the HG group and 85.7% in the RPE/HG group significantly greater than those of the CG. No statistically significant difference was found for the prevalence of successful subjects between the HG and RME/HG groups (P < 0.001)
Bacetti (2009)RCTPDCs: diagnosed from PA radiographs according to the method by Sambataro et al.2 groups 1. RPE group 2. CGTotal 54 subjects 1. RPE group: 32 subjects (with 42 PDCs) M/F = 12/20 8.8 years ± 9 months 2. CG: 22 subjects (with 31 PDCs) M/F = 8/14, 8.4 years ± 1 yearPA cephalograms, panoramic radiographs and measurement on dental castFull eruption of maxillary canine1. TG: 4.4 years, 3 dropouts 2. CG: 4.11 years, 3 dropoutsThe rates for successful eruption of the maxillary canines were 65.7% in the RPE group, and 13.6% in the CG. The different is statistically significant (P<0.001)
Bacetti (2011)RCTPDCs: diagnosed from panoramic radiographs according to the method by Ericson and Kurol4 groups 1. RPE/TPA/EC group: RPE followed by TPA therapy, and extraction of deciduous canines 2. TPA/EC group: TPA extraction of deciduous canines 3. EC group: extraction of deciduous canines 4. CGTotal 117 subjects 1. RPE/TPA/EC group: 40 subjects (with 66 PDCs) M/F = 15/25, 10y5m ± 10m 2.TPA/EC group: 24 subjects (with 36 PDCs) M/F = 10/14, 10y9m ± 11m 3. EC group:24 subjects (with 34 PDCs) M/F = 10/14 11y1m ± 11m 4. CG:29 subjects (with 42 PDCs) M/F = 11/18, 10y5m ± 10mClinical examination, panoramic and lateral cephalogramThe full eruption of the canine, thus permitting bracket positioning for final arch alignment with an early permanent dentition and a post-pubertal stage of cervical vertebral maturation (CS 5 or CS 6)1. RPE/TPA/EC group: 3y6m ± 16m, no dropout 2. TPA/EC group: 2y9m ± 13m, 1 dropout 3. EC group: 2y2m ± 10 m, 1 dropout 4. CG: 3y1m ± 14m, 1 dropoutThe rate of successful eruption of the maxillary canines was 80% for the RME/TPA/EC group, 79.2% for the TPA/EC group, 62.5% for the EC group, and 27.6% in the CG. There are statistically significant differences between all the groups (P<0.05), with the exception of the RME/TPA/EC group vs. TPA/EC group
Barros (2018)pCCTEctopic eruption of at least 1 maxillary canine overlapping sector II, III, or IV of the lateral incisor roots, diagnosed from panoramic radiographs, according to the method of Lindauer et al.3 groups 1. ECC: ectopically erupting canines with RPE 2. NEC: normally erupting canines with RPE 3. CGTotal 77 subjects 1. EEC group: 32 subjects (with 49 ectopically erupting canines) (M/F = 13/19, 9.53 years ± 1.10 year 2. NEC group: 18 subjects (9 expanded subjects from the EEC group with unilateral normally erupting canines) (with 27 normally erupting canines) M/F = 8/10, 9.25 years ± 1.06 year 3. CG: 36 subjects (with 54 normally erupting canines) M/F = 17/19 ,9.03 years ± 0.72 yearPanoramic radiographsAll groups: 1 yearThe ECC and NEC groups had greater angular, vertical, and horizontal canine improvements. RME had a positive impact on the eruption path of both the ectopically and normally erupting canines
Sigler 2011pCCTPDCs: intraosseous malposition of maxillary permanent canine diagnosed from panoramic radiographs according to the method of Ericson and Kurol2 groups 1. RPE/TPA/EC group: RPE followed by TPA and extraction of deciduous canines 2. CGTotal 68 subjects 1. RPE/TPA/EC group: 39 subjects (with 65 PDCs) M/F = 15/24, 10y5m ± 10 m 2. CG: 29 subjects (with 48 PDCs) M/F = 12/17,10y5 m ± 10 mPanoramic radiograph, lateral cephalogram and measurement on dental castThe full eruption of the canine, thus permitting bracket positioning for final arch alignment when needed1. RPE/TPA/EC group: 3 years 7 months, 1 dropout 2. CG: 3 years 1 month, 1 dropoutThe rates for successful eruption of the maxillary canines were 80% in the RPE/TPA/EC group, and 28% in the CG. The different is statistically significant (P<0.001)

Quality assessment of the included studies_

StudyYearStudy designEvidence level
Bacetti et al.2009RCT1b
Sigler et al.2011pCCT2b
Armi et al.2011RCT1b
Bacetti et al.2011RCT1b
Barros et al.2018pCCT2b

Inclusion and exclusion criteria_

Inclusion criteriaExclusion criteria
1. Randomized controlled trials and prospective clinical controlled trails1. Review article, retrospective studies, case report, personal opinion, systematic review
2. Human studies2. Animal studies, In vitro studies
3. Published in English only3. Non-English articles
4. Clear study design
DOI: https://doi.org/10.21307/aoj-2021.030 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 273 - 283
Published on: Oct 1, 2021
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2021 Supatchai Boonpratham, Natnicha Pariyatdulapak, Thongchai Poonpiriya, Supakit Peanchitlertkajorn, Nuntinee Nanthavanich Saengfai, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.