Table 3. Relationship of the treatment of the impacted upper canines or second premolars and their dependence on the
treatment plan with distalization of the upper molars using the Pendulum appliance.
Teeth
Impacted teeth without
upper canines
Uni- and by-lateraly
impacted upper canines
Statistic
N
%
N
%
N
Total
%
Impacted teeth without
N
upper second molars
%
Uni- and by-lateraly impacted
N
upper second premolars
%
N
Total
%
Treatment type
Non-tretated by Pendulum
Tretated by Pendulum
61
13
43.6
31.0
79
29
56.4
69.0
140
42
100.0
100.0
118
27
84.3
64.3
22
15
15.7
35.7
140
42
100.0
100.0
relationship was found between the impacted teeth
and the treatment by Pendulum. According to the
findings, in 23.1% of the patients with impacted teeth
we have used this method to achieve the necessary
space in the upper jaw for the teeth alignment. In
patients without impacted teeth the percentage is
significantly lower - 16.5%.
Canines and second premolars are the most
frequently impacted teeth in the upper jaw. That is
why the analysis looked at which of them have been
treated more often with the method of distalization
of the upper molars (Table 3). The analysis was
based on the use of the Chi-Square test which shows
that in the upper jaw the unilateral and by-lateral
form of retention of the upper canines are present
in 79 patients and 29 of them are treated with the
Pendulum appliance. The retention of the second
premolars in the upper jaw was found in 22 patients.
Fifteen of all patients were treated with Pendulum
appliance.
The table presents statistically significant results. It
creates the ground to say that distalization of the
upper molars using the Pendulum appliance is a
good and effective method to generate space
in the arch and for the successful extrusion and
introducing of the impacted or ectopic moved
second premolars. There was no significant
association found in the distalisation stage of the
impacted upper canines during the treatment of
the upper molars.
Reasonably, what could be raised is the question
whether the age when the patient is diagnosed
and treated is relevant to the choice of the
treatment method. Therefore, we examined the
hypothesis whether there is a correlation between
the age when the treatment starts and the type
of therapeutic approach used. The Independent
Samples t-test used showed that the difference
in age was statistically significant t (58)=2.64,
p=0.011. (Table 4)
Patients in the early growth period have a better
chance of Non-extraction treatment than those
who have finished with the formation of the
constant dentition and have passed the peak of
their puberty growth. In the second category of
Stomatology Edu Journal
Total
74
40.7
108
59.3
182
100.0
145
79.7
37
20.3
182
100.0
p
0.144
0.005
patients the extraction therapeutic approach is
applied more frequently.
There are greater opportunities in the distalization
of the upper molars to include the second premolar
tooth in an arc because of the open distal relocation
site which coincides with the shortage of space in an
impacted premolar. Such a therapeutic approach in
an impacted canine is less successful because the
location of the distal movement of the upper molars
is opened in the area of the second premolars. To
achieve space in the canines’ zone what is necessary
is the distal displacement of the two premolars, and
this is associated with the loss of space in the bearing
region and also at the molar area.
IMPACTION OF TEETH - FREQUENCY AND MOST OFTEN USED TREATMENT PROTOCOLS
4. Discussion
Gisakis, 11 carried some research among the Greek
in 2011 and found that in 82.7% of the patients with
impaction there is related orthodontic deformation.
All patients studied by us also have a concomitant
orthodontic problem, most often its cause is
impacted teeth. Gündüz 12 published a report on
research carried out among the Turks in which he
states that the prevalence of impacted teeth is 9.2%
and the ratio male/female is 1:1.4. The upper canines
are most likely to be impacted (71.5%) followed
up by lower premolars (8.6%). Topkara et al. 13
researched orthodontic patients and found out that
the canines are the most likely teeth to be affected
by impaction (5.24%), followed by the lower second
premolars (2.23%), the upper lower premolars
(1.11%), lower canines (0.92%), molars (0.72%) and
incisors (0.65%). Our findings show that the retention
of the upper second premolar is second (27.4%) in
frequency to the upper canines (75.3%). This result
differs from the data of these authors, whose results
show that second in frequency are the lower second
premolars (our result – 14.8%). Clinically, this result
can be explained by the higher frequency of the
caries damage in the second temporary molars and
the shorter time needed for medial movement of the
upper first permanent molars. The Spee curve eases
the medialization of the upper first permanent molar,
while the more compact structure of the lower jaw
slightly delays the medialization of the lower first
permanent molar. That is why the second premolar
267