Optimizing orthodontic treatment for delayed eruption of permanent anterior teeth: A prospective study using a modified appliance.

Abstract

Delayed permanent anterior teeth eruption, accompanied by insufficient space in the dental arch, presents a significant challenge during mixed dentition. The aim of this study was to assess the effectiveness of a modified orthodontic appliance that combines transverse maxillary expansion and mesio-distal maxillary elongation, with controlled distalization of permanent molars, in treating cases of delayed anterior teeth eruption during the mixed dentition period. The present study included a prospective comparative design, with a study group of 35 patients and a control group of 32 patients, all demonstrating clinical and radiological signs of delayed permanent anterior teeth eruption. The study group received treatment with a modified orthodontic appliance designed to achieve both maxillary expansion and molar distalization simultaneously. The control group was treated with the Haas appliance for maxillary expansion and the Distal Jet for molar distalization. The level of significance was determined using statistical tests, with p-values calculated for key outcomes. The study revealed that the modified orthodontic appliance significantly reduced the treatment time required for adequate space creation within the dental arch compared to the control group (p = 0.017). The rate of complications in the study group was lower (17.14%) compared to the control group (28.12%), with a significant difference (p = 0.046). Patients in the study group also reported a higher rate of positive perception (68.57%) compared to the control group (43.75%), with a statistically significant difference (p = 0.031). No significant difference was found in the amount of molar distalization and maxillary expansion between the two groups (p > 0.05). A redesigned orthodontic appliance that combines transverse maxillary expansion and molar distalization reduces treatment time and difficulties in delayed permanent anterior teeth eruption. These data indicate that the appliance improves treatment efficiency and patient comfort without reducing spatial adjustments. Its mixed dentition use needs more research with larger sample sizes and regulated treatment techniques.