Spontaneous eruption of impacted maxillary incisors after surgical extraction of supernumerary teeth: a systematic revie
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ORIGINAL ARTICLE
Spontaneous eruption of impacted maxillary incisors after surgical extraction of supernumerary teeth: a systematic review and meta-analysis Raji Pescia 1
&
Stavros Kiliaridis 1 & Gregory S. Antonarakis 1
Received: 12 December 2019 / Accepted: 21 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To evaluate the spontaneous eruption potential of impacted human permanent teeth localized in the anterior part of the maxilla, after the surgical extraction of obstacles in their eruption pathway, by means of a systematic review and meta-analysis. Materials and methods A systematic literature search was carried out to locate studies reporting on the percentage of anterior permanent teeth erupting after surgical removal of the obstacle, without other interventions. Eruption potential of impacted teeth was calculated using a random-effects meta-analysis. Information about the sex proportion, follow-up duration, age and years during which the study was carried out was used for subgroup analyses. Results A total of twelve studies were included, with a total sample size of 960 cases and a follow-up period of up to 36 months. The results show that more than 65.5% of impacted teeth erupt spontaneously following surgical extraction of the obstacle, with an odds ratio of 4 (95% CI 1.9, 8.2) (p < 0.001) favouring spontaneous eruption. Conclusions When faced with an impacted maxillary anterior tooth, surgical extraction of the obstacle can lead to spontaneous eruption of the impacted tooth in the majority of cases, with better success with a longer follow-up for up to 3 years. Clinical relevance Based on the present meta-analysis, clinical recommendation would be to surgically remove the obstacle impeding the eruption of a maxillary anterior permanent tooth and wait for the eruption of the tooth for a period of 12–36 months, depending on the age of the patient. Keywords Impacted teeth . Spontaneous eruption . Supernumerary teeth . Systematic review . Mesiodens . Meta-analysis
Introduction The prevalence of impacted maxillary anterior teeth is around 0.8–8.4% for canines [1–5] and 0.2–0.5% for incisors [1, 6]. It is not clear however what percentage of these impactions occur in the presence of an obstacle or a supernumerary tooth. Supernumerary teeth are most often found in the anterior area of the maxilla [5]. The presence of an obstacle such as a supernumerary tooth, an odontoma or a cyst [7] in the path of eruption of a permanent maxillary incisor or canine can have important functional, aesthetic and social implications
* Raji Pescia [email protected] 1
Department of Orthodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, 1 rue Michel-Servet, 1205 Geneva, Switzerland
if there is a lack of proper management of the patient in terms of interventions and their timing. Early diagnosis of a supernumerary tooth is essential to reduce possible complications, surgical re-intervention and complex and lengthy orthodontic treatments [8
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