Clinical efficacy of early intervention timing for inversely impacted maxillary central incisors

Background: Maxillary Impacted Central Incisors are a common oral issue among children with mixed dentition. This study evaluates the effectiveness of early traction treatment, which is vital for clinical treatment and management. Methods: This study included 59 patients with maxillary impacted central incisors, who were divided into three groups based on Nolla's method: the early group (Nolla 6-7), middle group (Nolla 8), and late group (Nolla 9-10). Mimics software was used to create 3 Dimensions (3D) reconstructions of postoperative Cone-beam computed tomography (CBCT) scans, which were used to compare the tooth volume and surface area between the impacted and contralateral teeth, as well as sagittal measurements of root length and loss of height on the labial-palatal aspects of the alveolar bone. Doppler laser flowmetry was used to assess pulpal blood flow in impacted and contralateral teeth three months after surgery. Results: Significant differences in root length, tooth volume, and surface area were observed between impacted and contralateral teeth in the middle and late groups (p < 0.05). The early group, however, showed significant differences in the labial-palatal height differential of the alveolar bone between the impacted teeth and their contralateral counterparts compared to the middle and late groups (p <0.05). The study found no significant differences in pulpal vitality among the three groups (p > 0.05). Conclusions: The study's results indicate that orthodontic treatment during Nolla stages 6-7 is more beneficial in the development of impacted teeth in patients. This study supports the early orthodontic treatment approach in clinical practice.