Management of impacted incisors following surgery to remove obstacles to eruption: a prospective clinical trial.

PURPOSE: The purpose of this study was to assess the effectiveness of rapid maxillary expansion (RME) vs simply monitoring the eruption of permanent maxillary incisors following the surgical removal of obstacles to their eruption (supernumerary teeth, odontomas). METHODS: Following surgical removal of the obstacles to incisor eruption (T1), 62 patients were randomly assigned to either the group to undergo RME (34 subjects; mean age 8 years, 11 months +/- 11 months) or the group that was monitored without further treatment (28 subjects; mean age=9 years, 1 month +/- 1 year). At T2 (1 year after T1), the prevalence rate of erupted incisors was recorded. Also, the time of eruption of the incisors and the amount of space loss were analyzed. RESULTS: At T2, eruption of impacted incisors occurred in approximately 82 percent of the RME group cases vs approximately 39 percent of the monitored group cases (chi-square=10.43, P<.001). Time of eruption was significantly faster in the RME group, and anterior space loss significantly smaller. CONCLUSIONS: Rapid maxillary expansion treatment following surgical removal of the obstacles to the eruption of permanent maxillary incisors appears to be an efficient interceptive approach leading to eruption of the incisors in four out of five cases within seven months.