Article Data

  • Views 3033
  • Dowloads 702

Original Research

Open Access

The design and clinical application of a new appliance to treat impacted maxillary central incisors

  • Yuqi Peng1
  • Zhaohao Zhen1
  • Huanhuan Qiu1
  • Meimei Li1
  • Huacui Xiong1,*,
  • Ke Chen1,*,

1Stomatological Hospital, Southern Medical University, 510115 Guangzhou, Guangdong, China

DOI: 10.22514/jocpd.2023.010 Vol.47,Issue 2,March 2023 pp.40-49

Submitted: 08 September 2022 Accepted: 10 November 2022

Published: 03 March 2023

*Corresponding Author(s): Huacui Xiong E-mail:
*Corresponding Author(s): Ke Chen E-mail:


Maxillary central incisor impaction is one of the most common types of dental anomalies in children. Treatment of impacted central incisors is complicated and challenging given the position of the impacted central incisors, root development, and the complexity of the crown eruption direction. This study aimed to describe the use of a new multifunctional appliance for the treatment of impacted maxillary central incisors. This article reports the use of a novel appliance for the treatment of impacted maxillary central incisors. We describe the cases of two young patients with labial horizontally impacted maxillary central incisors. Both patients were treated using this novel appliance. Therapeutic effects were evaluated by comparing the pretreatment results, posttreatment cone-beam computed tomography images, and posttreatment clinical examination results. At the end of the treatment period using the novel appliance, the impacted central incisors had successfully been properly aligned in the dental arch, and the tooth roots had not resorbed. Both patients exhibited good dental alignment, with restored function and acceptable aesthetics. This article demonstrates that the new appliance was comfortable, convenient, safe, and effective in the treatment of impacted maxillary central incisors and that its clinical use should be promoted in the future.


Impacted teeth; Oral appliance; Orthodontic treatment

Cite and Share

Yuqi Peng,Zhaohao Zhen,Huanhuan Qiu,Meimei Li,Huacui Xiong,Ke Chen. The design and clinical application of a new appliance to treat impacted maxillary central incisors. Journal of Clinical Pediatric Dentistry. 2023. 47(2);40-49.


[1] Yaqoob O, O’Neill J, Gregg T, Noar J, Cobourne M, Morris D. Management of unerupted maxillary incisors. 2010. Available at: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/ Eng_2010._Management_of_Unerupted_Maxillary_Incisors. pdf (Accessed: April 2010).

[2] Al-Zoubi H, Alharbi AA, Ferguson DJ, Zafar MS. Frequency of impacted teeth and categorization of impacted canines: a retrospective radiographic study using orthopantomograms. European Journal of Dentistry. 2017; 11: 117–121.

[3] Tan C, Ekambaram M, Yiu CKY. Prevalence, characteristic features, and complications associated with the occurrence of unerupted permanent incisors. PLoS One. 2018; 13: e0199501.

[4] Hui J, Niu Y, Jin R, Yang X, Wang J, Pan H, et al. An analysis of clinical and imaging features of unilateral impacted maxillary central incisors: a cross-sectional study. American Journal of Orthodontics and Dentofacial Orthopedics. 2022; 161: e96–e104.

[5] Verma S, Singh SP, Verma RK, Kumar V, Singh S, Bhupali NR. Success rate, treatment duration, and pain perception in the management of palatally impacted canines using the K9 and Ballista spring: a randomized clinical trial. The Angle Orthodontist. 2022. [Preprint].

[6] Pavoni C, Franchi L, Laganà G, Baccetti T, Cozza P. Management of impacted incisors following surgery to remove obstacles to eruption: a prospective clinical trial. Pediatric Dentistry. 2013; 35: 364–368.

[7] Lana Mattiello FD, Deon Rizzatto SM, Macedo de Menezes L, Araújo EA, Kim KB, Martinelli de Lima E. Dimensional and morphologic characteristics of unilateral impacted maxillary central incisors. American Journal of Orthodontics and Dentofacial Orthopedics. 2022; 162: 340–347.

[8] Shi R, Zhou Z, Li P, Shi L, Sun H, Bai Y. In situ rotation surgery for correction of growing, inversely impacted maxillary central incisors. American Journal of Orthodontics and Dentofacial Orthopedics. 2021; 159: 536–544.

[9] Shi X, Sun X, Wang X, Zhang C, Liu Y, Quan J, et al. The effect of the root dilaceration on the treatment duration and prognosis of unilateral impacted immature maxillary central incisors. American Journal of Orthodontics and Dentofacial Orthopedics. 2022. [Preprint].

[10] Tai K, Shin J, Park JH, Sato Y. A modified palatal appliance for forced eruption of impacted central incisor. Journal of Clinical Pediatric Dentistry. 2019; 43: 424–431.

[11] Nallanchakrava S, Mettu S, Reddy NG, Jangam K. Multidisciplinary approach for the management of dilacerated permanent maxillary incisor: a case report. International Journal of Clinical Pediatric Dentistry. 2020; 13: 725–728.

[12] Pavlidis D, Daratsianos N, Jäger A. Treatment of an impacted dilacerated maxillary central incisor. American Journal of Orthodontics and Dento-facial Orthopedics. 2011; 139: 378–387.

[13] Chokron A, Reveret S, Salmon B, Vermelin L. Strategies for treating an impacted maxillary central incisor. International Orthodontics. 2010; 8: 152–176.

[14] Ayers E, Kennedy D, Wiebe C. Clinical recommendations for management of mesiodens and unerupted permanent maxillary central incisors. European Archives of Paediatric Dentistry. 2014; 15: 421–428.

[15] Manilla AE, Katagiri MK. Orthodontic-surgical treatment of an impacted central incisor. Case report. The Mexican Journal of Orthodontics. 2017; 5: e184–e189.

[16] Cosme-Silva L, Costa E Silva LL, Junqueira MA, de Oliveira Dias NN, da Silveira Moretti AB, Sakai VT. Combined surgical removal of a supernumerary tooth and orthodontic traction of an impacted maxillary central incisor. Journal of Dentistry for Children. 2016; 83: 167–172.

[17] Jain S, Raza M, Sharma P, Kumar P. Unraveling impacted maxillary incisors: the why, when, and how. International Journal of Clinical Pediatric Dentistry. 2021; 14: 149–157.

[18] Žarovienė A, Grinkevičienė D, Trakinienė G, Smailienė D. Post-treatment status of impacted maxillary central incisors following surgical-orthodontic treatment: a systematic review. Medicina. 2021; 57: 783.

[19] Topouzelis N, Tsaousoglou P, Pisoka V, Zouloumis L. Dilaceration of maxillary central incisor: a literature review. Dental Traumatology. 2010; 26: 427–433.

[20] Weinstein C, Alarcón C, Flores-Mir C, Dupré C, Hirschhaut M. Orthodontic and periodontal considerations in maxillary central incisor impactions: case series. AJO-do Clinical Companion. 2022; 2: 372–386.

[21] Grisar K, Luyten J, Preda F, Martin C, Hoppenreijs T, Politis C, et al. Interventions for impacted maxillary canines: a systematic review of the relationship between initial canine position and treatment outcome. Orthodontics & Craniofacial Research. 2021; 24: 180–193.

[22] Andrade I Jr, Paschoal MA, Santos TO. Spontaneous eruption of severely impacted teeth: the report of two cases. Journal of Clinical and Experimental Dentistry. 2019; 11: e491–e495.

[23] Hyomoto M, Kawakami M, Inoue M, Kirita T. Clinical conditions for eruption of maxillary canines and mandibular premolars associated with dentigerous cysts. American Journal of Orthodontics and Dentofacial Orthopedics. 2003; 124: 515–520.

[24] Li J, Parada C, Chai Y. Cellular and molecular mechanisms of tooth root development. Development. 2017; 144: 374–384.

[25] Sun H, Hu R, Ren M, Lin Y, Wang X, Sun C, et al. The treatment timing of labial inversely impacted maxillary central incisors: a prospective study. The Angle Orthodontist. 2016; 86: 768–774.

[26] Suri L, Gagari E, Vastardis H. Delayed tooth eruption: Pathogenesis, diagnosis, and treatment. a literature review. American Journal of Orthodontics and Dentofacial Orthopedics. 2004; 126: 432–445.

[27] Topouzelis N, Tsaousoglou P, Gofa A. Management of root dilaceration of an impacted maxillary central incisor following orthodontic treatment: an unusual therapeutic outcome. Dental Traumatology. 2010; 26: 521–526.

[28] McNamara T, Woolfe SN, McNamara CM. Orthodontic management of a dilacerated maxillary central incisor with an unusual sequela. Journal of Clinical Orthodontics. 1998; 32: 293–297.

[29] Sendyk M, Linhares DS, Pannuti CM, Paiva JB, Rino Neto J. Effect of orthodontic treatment on alveolar bone thickness in adults: a systematic review. Dental Press Journal of Orthodontics. 2019; 24: 34–45.

[30] Shi X, Xie X, Quan J, Wang X, Sun X, Zhang C, et al. Evaluation of root and alveolar bone development of unilateral osseous impacted immature maxillary central incisors after the closed-eruption technique. American Journal of Orthodontics and Dentofacial Orthopedics. 2015; 148: 587–598.

[31] Hu H, Hu R, Jiang H, Cao Z, Sun H, Jin C, et al. Survival of labial inversely impacted maxillary central incisors: a retrospective cone-beam computed tomography 2-year follow-up. American Journal of Orthodontics and Dentofacial Orthopedics. 2017; 151: 860–868.

[32] Alberto PL. Surgical exposure of impacted teeth. Oral and Maxillofacial Surgery Clinics of North America. 2020; 32: 561–570.

[33] Farronato G, Giannini L, Galbiati G, Maspero C. A 5-year longitudinal study of survival rate and periodontal parameter changes at sites of dilacerated maxillary central incisors. Progress in Orthodontics. 2014; 15: 3.

[34] Migliario M, Rizzi M, Lucchina AG, Renò F. Diode laser clinical efficacy and mini-invasivity in surgical exposure of impacted teeth. The Journal of Craniofacial Surgery. 2016; 27: e779–e784.

[35] Seifi M, Matini NS. Laser surgery of soft tissue in orthodontics: review of the clinical trials. Journal of Lasers in Medical Sciences. 2017; 8: S1–S6.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time