RESUMO Introdução: O longo caminho que os caninos percorrem até irromper na arcada superior os torna vulneráveis a interrupções durante a erupção fisiológica. A etapa de planejamento do tratamento para caninos superiores impactados (CSI) apresenta desafios significativos, destacando a necessidade de consideração cuidadosa e expertise. Objetivo: O objetivo do presente artigo é esclarecer esses aspectos, discutindo relatos de casos clínicos envolvendo CSI, fornecendo percepções sobre a complexidade de seu manejo. Conclusões: O manejo do CSI na Ortodontia apresenta um desafio multifacetado, que inclui a necessidade de um diagnóstico preciso, o uso prudente de tomografia computadorizada de feixe cônico (TCFC), a seleção estratégica entre as técnicas de exposição aberta ou fechada, uma compreensão aprofundada da biomecânica ortodôntica específica envolvida, e uma consciência ampla dos possíveis resultados adversos, como anquilose, tempo de tratamento prolongado, reabsorção radicular e complicações adicionais. Introdução fisiológica (CSI significativos expertise Objetivo aspectos Conclusões multifacetado preciso TCFC, TCFC , (TCFC) fechada envolvida adversos anquilose prolongado adicionais (TCFC

ABSTRACT Introduction: The long pathway that the canines take as they emerge into the maxillary arch makes them vulnerable to disruption during their natural emergence time. The process of planning treatment for impacted maxillary canine (IMC) presents significant challenges, underscoring the need for careful consideration and expertise. Objective: The aim of this article was to shed light on these complexities by discussing clinical case studies involving IMC, providing insights into the intricacies of their management. Conclusions: The management of IMC within orthodontics presents a multifaceted challenge that include the necessity for precise diagnostic processes, prudent use of cone beam computed tomography (CBCT), the strategic selection between open and closed exposure techniques, a in-depth understanding of the specific orthodontic biomechanics involved, and a keen awareness of potential adverse outcomes such as ankylosis, prolonged treatment times, root resorption, and additional complications. Introduction time (IMC challenges expertise Objective Conclusions processes CBCT, CBCT , (CBCT) techniques indepth in depth involved ankylosis times resorption complications (CBCT

RESUMO Introdução: A técnica de decoronação é descrita na literatura desde 1984 e, com base nos resultados disponíveis, pode trazer benefícios consideráveis para o reparo e reabilitação de dentes anquilosados. Com base nesses relatos, seria esperado que esse procedimento fosse bem conhecido pela comunidade odontológica. No entanto, isto não parece ser verdadeiro e esse procedimento não é amplamente utilizado. Objetivo: O objetivo deste artigo é apresentar literatura adequada que discuta a decoronação e avalie as perspectivas do procedimento, tanto em relação à técnica quanto aos benefícios em longo prazo para o paciente. Métodos: Foi realizada revisão integrativa da literatura nas bases de dados PubMed, SciELO e Lilacs, utilizando as seguintes palavras-chave: “decoronation”, “ridge preservation decoronation”, “decoronation ankylosis”. Além disso, um relato de caso demonstrará a técnica de maneira sistemática e detalhada. Resultados: Considerando os critérios de inclusão, foram selecionados 27 artigos que apresentam consistência quanto à decoronação. Conclusão: Há escassa disponibilidade de trabalhos científicos relacionados ao tema para corroborar e discutir a técnica. Esse artigo reforça os benefícios desse procedimento e revisa a decoronação na tentativa de fornecer um possível tratamento para dentes anquilosados em pacientes em crescimento. Introdução 198 disponíveis relatos odontológica entanto utilizado Objetivo paciente Métodos PubMed Lilacs palavraschave palavras chave palavras-chave decoronation, decoronation , “decoronation” ridge decoronation” ankylosis. ankylosis . ankylosis” disso detalhada Resultados inclusão 2 Conclusão crescimento 19 1

ABSTRACT Introduction: The decoronation technique has been described in literature since 1984 and, based on the available results, it can lead to considerable benefits for the repair and rehabilitation of ankylosed teeth. Based on these reports, one could expect that this procedure would be well known by the dental community. However, this fact does not seem to be true, and this procedure is not widely used. Methods: The objective of this paper is to present appropriate literature that discusses decoronation and evaluate the perspectives of the procedure, both in relation to the technique and the long-term benefits for the patient. An integrative literature review at PubMed, ScieELO, and Lilacs databases was performed using the keywords “decoronation”, “ridge preservation decoronation”, “decoronation ankylosis”. In addition, a case report will be presented to demonstrate the technique in a systematic and detailed manner. Results: Considering the inclusion criteria, 27 articles that present consistency regarding decoronation were selected. Conclusion: There is scarce availability of scientific works related to the topic, to corroborate and discuss the technique. The present paper reinforces the benefits of this procedure, and revisit decoronation, attempting to provide a possible treatment for ankylosed teeth in growing patients. Introduction 198 results reports community However true used Methods longterm long term patient PubMed ScieELO , “decoronation” ridge decoronation” ankylosis. ankylosis . ankylosis” addition manner Results criteria 2 selected Conclusion topic patients 19 1

Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12–9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31–10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09–1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11–1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00–1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC. (PDC PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE CENTRAL Scopus topic assessed metaanalysis meta eruption approach 89 studies 1 fulltext full text metaanalysis, analysis, 50 73 intervention. . intervention) Furthermore (RME relative RR 268 2 68 2.6 ICr95% ICr95 ICr 1.12–9.35. 112935 1.12–9.35 12 35 1.12–9.35) 307 3 07 3.0 1.31–10.67, 1311067 1.31–10.67 , 31 10 67 1.31–10.67) (TA s canine(s (EC 143 43 1.4 1.09–1.95, 109195 1.09–1.95 09 95 1.09–1.95) 138 38 1.3 1.11–1.79, 111179 1.11–1.79 11 79 1.11–1.79) 136 36 1.00–1.9 10019 00 Overall indirectness conclusion 8 5 7 26 6 2. ICr9 11293 1.12–9.3 30 0 3. 131106 1.31–10.6 14 4 1. 10919 1.09–1.9 13 11117 1.11–1.7 1.00–1. 1001 1129 1.12–9. 13110 1.31–10. 1091 1.09–1. 1111 1.11–1. 1.00–1 100 112 1.12–9 1311 1.31–10 109 1.09–1 111 1.11–1 1.00– 1.12– 131 1.31–1 1.09– 1.11– 1.00 1.12 1.31– 1.09 1.11 1.0 1.1 1.31