Cochrane · intervention · CD004621
Extraction of primary (baby) teeth for unerupted palatally displaced permanent canine teeth in children
Cochrane Database of Systematic Reviews · 2012 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
8
current version
GRADE rated
0
No studies
2
Included studies
2
as reported
No studies 2 · 25%Ungraded 6 · 75%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children with palatally displaced maxillary canines (at least 80% aged 10 to 13 years); trials with craniofacial syndromes or anomalies excluded | 70 children completing treatment across 2 included trials (Baccetti 2008: 69 of 75 enrolled; Leonardi 2004: 46 of 50 enrolled), around 8 to 13 years of age; participants had unilateral or bilateral palatally displaced canines (148 PDCs total) |
| Intervention | Extraction of the primary maxillary canine | Extraction of the primary maxillary canine (n=34 children); Extraction of the primary maxillary canine plus cervical pull headgear (n=45 children) |
| Comparison | No treatment, delayed treatment, or an alternative treatment such as extraction plus the use of headgear | Untreated control group - no extraction and no headgear (n=36 children) |
| Outcomes | Primary: reported prevalence of eruption or non-eruption of the permanent canine into the mouth. Secondary: (1) improvement in the vertical position or angulation of the ectopic canine, measured from radiographs; (2) incidence or prevalence of root resorption of the impacted canine and/or incisors and cyst formation; (3) patient satisfaction and pain experience during extraction of the primary canine | Successful eruption of the palatally displaced permanent canine (n=2); Time to eruption of the permanent canine (n=2); Change in the sagittal position of the upper first molars (n=1); Changes in the inclination of the canine to the midline (n=2); Distance of the permanent canine cusp tip to the occlusal line (n=2); Medial position of the canine tooth crown (n=2) |
| Study designs | Randomised controlled trials (RCTs) or quasi-RCTs with at least a 6-month follow-up, restricted to parallel group studies (cross-over and split-mouth designs excluded) | 2 RCTs (3 trial reports); both at high overall risk of bias (no reported random sequence generation or allocation concealment; no outcome assessor blinding; high risk of selective reporting; baseline imbalance) |
| Timing | At least a 6-month follow-up after the intervention | Follow-up around 18 to 48 months (reporting inconsistent); Baccetti 2008 reported eruption success at 4 years |
Search date: 2012-04. Databases: The Cochrane Oral Health Group's Trials Register; The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via OVID; EMBASE via OVID
Questions and results
Show all 3 versionsExtraction of the primary maxillary canine vs Untreated control (no treatment)
Population: Children with palatally displaced maxillary canines (at least 80% aged 10 to 13 years); trials with craniofacial syndromes or anomalies excluded
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to eruption of the permanent canine At least 6 months follow-up after the intervention | Time to eruption of the permanent canine was reported by both trials. The paper reports there was 'no significant difference between the two interceptive approaches in the time required for canine eruption' (extraction… | 2 studies | Ungraded |
Patient satisfaction and pain experience during extraction of the primary canine At least 6 months follow-up after the intervention | Neither trial reported the outcome of pain, or patient satisfaction. | 0 studies | No studies |
Improvement in the vertical position or angulation of the ectopic canine, measured from radiographs (inclination to midline, cusp-tip to occlusal line, medial crown position) At least 6 months follow-up after the intervention | Changes in the position of the displaced canine measured from radiographs, reported by both trials as medians (non-normal distribution): changes in the inclination of the canine to the midline, the distance of the… | 2 studies | Ungraded |
Incidence or prevalence of root resorption of the impacted canine and/or incisors and cyst formation At least 6 months follow-up after the intervention | Root resorption of the impacted canine and/or incisors and cyst formation was not reported by either included trial. | 0 studies | No studies |
Change in the sagittal position of the upper first molars At least 6 months follow-up after the intervention | Change in the sagittal position of the upper first molars (Baccetti 2008 only): average sagittal displacement was 2.65 mm in the extraction-only group and 2.32 mm in the untreated control group (0.24 mm in the… | 1 study | Ungraded |
Prevalence of eruption/non-eruption of the palatally displaced permanent canine (successful eruption) At least 6 months follow-up after the intervention | Narrative summary (data not poolable, not GRADE-rated). Leonardi 2004: successful eruption of the permanent canine 50% in the extraction-only group, which was not significantly greater than the success rate in… | 2 studies · 70 participants | Ungraded |
Extraction of the primary maxillary canine plus cervical pull headgear vs Untreated control (no treatment)
Population: Children with palatally displaced maxillary canines (at least 80% aged 10 to 13 years); trials with craniofacial syndromes or anomalies excluded
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prevalence of eruption/non-eruption of the palatally displaced permanent canine (successful eruption) At least 6 months follow-up after the intervention | Narrative (not pooled, not GRADE-rated). Leonardi 2004: successful eruption 80% with extraction plus cervical pull headgear, significantly higher than the untreated control group (Chi2 14.9; P<0.01). Baccetti 2008: the… | 2 studies · 81 participants | Ungraded |
Extraction of the primary maxillary canine plus cervical pull headgear vs Extraction of the primary maxillary canine alone
Population: Children with palatally displaced maxillary canines (at least 80% aged 10 to 13 years); trials with craniofacial syndromes or anomalies excluded
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prevalence of eruption/non-eruption of the palatally displaced permanent canine (successful eruption) At least 6 months follow-up after the intervention | Narrative (not pooled, not GRADE-rated). Leonardi 2004: extraction plus headgear (80%) gave significantly higher eruption than extraction alone (50%) (Chi2 4.69; P<0.05). Baccetti 2008: extraction plus headgear was… | 2 studies · 79 participants | Ungraded |