Wolny Mateusz, Sikora Agata, Olszewska Aneta, Matys Jacek, Czajka-Jakubowska Agata
Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
J Clin Med. 2025 May 14;14(10):3421. doi: 10.3390/jcm14103421.
The growing demand for esthetic, less painful, and more comfortable orthodontic treatment has led to increasing use of aligner systems. Initially used for less complicated malocclusions, aligners are now being incorporated into complex treatment plans, including cases involving impacted teeth. While aligners are a popular alternative to traditional fixed appliances, they still have limitations. This study aims to evaluate the effectiveness of aligner-based orthodontic treatment in patients with impacted or significantly ectopic canines. This study was conducted in accordance with the PRISMA guidelines. The search terms used were as follows: 'Clear Aligner' OR 'Invisalign' AND 'Impacted Canine' OR 'Impacted Tooth' OR 'Ectopic Tooth' OR 'Ectopic Canine.' A total of 1101 records were identified, of which 170 articles underwent screening. Fifteen articles were assessed for eligibility, and ultimately six case reports and one three-dimensional finite element analysis (FEA) study were included for both quantitative and qualitative synthesis. According to the studies, additional appliances are often required to achieve favorable outcomes when treating impacted canines with aligner systems. Temporary anchorage devices (TADs) were used in 5 out of 9 reported cases for canine traction into the dental arch. In three cases, TADs were combined with sectional wires implemented as cantilevers. Elastics were used in 6 out of 9 cases for traction to the opposite arch, and in 5 out of 9 cases as interarch elastics attached to the aligners. Interarch elastics were applied in various ways, either directly to the aligners or to primary canines using hidden buttons inside pontics or dovetail hooks. Elastics were also anchored to the lower arch with class II, class III, or cross-arch (criss-cross) mechanics. This review highlights the promising potential of aligner systems in the treatment of impacted canines. However, additional auxiliaries, such as TADs, sectional wires, or elastics remain nearly essential for initial canine traction. Aligner systems offer versatile treatment options, and the possibility of reduced treatment time represents a valuable area for future research.
对美观、疼痛更小且更舒适的正畸治疗的需求不断增长，导致矫治器系统的使用日益增加。矫治器最初用于不太复杂的错牙合畸形，如今已被纳入复杂的治疗方案，包括涉及阻生牙的病例。虽然矫治器是传统固定矫治器的一种流行替代方案，但它们仍有局限性。本研究旨在评估基于矫治器的正畸治疗对阻生或明显异位尖牙患者的有效性。本研究按照PRISMA指南进行。使用的检索词如下：“透明矫治器”或“隐适美”以及“阻生尖牙”或“阻生牙”或“异位牙”或“异位尖牙”。共识别出1101条记录，其中170篇文章接受筛选。评估了15篇文章的 eligibility，最终纳入了6篇病例报告和1项三维有限元分析（FEA）研究进行定量和定性综合分析。根据研究，在使用矫治器系统治疗阻生尖牙时，通常需要额外的矫治器才能取得良好效果。在9例报告病例中有5例使用了临时锚固装置（TADs）将尖牙牵引至牙弓。在3例病例中，TADs与作为悬臂使用的片段弓丝相结合。9例中有6例使用弹力牵引至对侧牙弓，9例中有5例作为附着于矫治器的颌间弹力牵引。颌间弹力牵引以多种方式应用，要么直接应用于矫治器，要么使用桥体内部的隐藏纽扣或燕尾钩应用于乳尖牙。弹力牵引也通过II类、III类或跨牙弓（交叉）力学固定于下牙弓。本综述强调了矫治器系统在治疗阻生尖牙方面的潜在前景。然而，额外的辅助装置，如TADs、片段弓丝或弹力牵引对于初始尖牙牵引几乎仍然是必不可少的。矫治器系统提供了多种治疗选择，减少治疗时间的可能性是未来研究的一个有价值领域。
