{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:05:18Z","timestamp":1780067118138,"version":"3.54.0"},"reference-count":44,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of orthodontic traction of impacted maxillary canines on treatment duration, alveolar bone levels, white spot lesions (WSLs), root resorption, and the need for auxiliary appliances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective study, 116 patients were divided into two groups: 58 with unilaterally impacted maxillary canines and 58 controls without impaction. All patients received nonextraction treatment using labial fixed appliances. Pretreatment and posttreatment panoramic radiographs, intraoral photographs, and intraoral scans were analyzed. The collected data were used to compare the groups across five clinical parameters. Statistical analyses included the Mann-Whitney\n                      <jats:italic>U<\/jats:italic>\n                      -test, Wilcoxon signed-rank test, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test, and Cochran\u2019s Q test, with significance set at\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The impaction group had significantly longer treatment duration (mean = 2.64 \u00b1 0.99 years) than controls (mean = 1.85 \u00b1 0.60 years). Alveolar bone loss was significantly greater in teeth adjacent to the impacted canine and between the impacted and nonimpacted sides within the impaction group (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). WSL incidence was higher in the impaction group, especially in posterior teeth (\n                      <jats:italic>P<\/jats:italic>\n                      = .0034). Root resorption patterns differed by region: maxillary incisors were more affected in the impaction group, whereas mandibular posterior teeth showed more resorption in controls. The use of auxiliary appliances was significantly greater in the impaction group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Impacted canine treatment is associated with increased treatment time, greater alveolar bone loss, higher risk of WSLs, and distinct root resorption patterns. These findings highlight the importance of individualized treatment planning, careful biomechanical control, and preventive strategies in managing impacted canines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/032125-227.1","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:31:50Z","timestamp":1759278710000},"page":"181-191","source":"Crossref","is-referenced-by-count":2,"title":["The impact of orthodontic traction on outcomes in impacted canine management: a quantitative analysis"],"prefix":"10.2319","volume":"96","author":[{"given":"Hilal","family":"Tarkan","sequence":"first","affiliation":[{"name":"Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Usak University, Usak, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oru\u00e7 \u00d6mer","family":"G\u00fcrb\u00fcz","sequence":"additional","affiliation":[{"name":"Student Intern, Faculty of Dentistry, Usak University, Usak, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"3","key":"i1945-7103-96-2-181-b01","series-title":"Br J Orthod","first-page":"209","article-title":"The ectopic maxillary canine: a review","volume":"25","author":"McSherry","year":"1998","unstructured":"McSherry PF. The ectopic maxillary canine: a review. Br J Orthod. 1998;25(3):209\u2013216. doi:10.1093\/ortho\/25.3.209"},{"issue":"7","key":"i1945-7103-96-2-181-b02","series-title":"Children (Basel)","first-page":"1006","article-title":"Evaluation of lateral incisor resorption caused by impacted maxillary canines based on CBCT: a systematic review and meta-analysis","volume":"9","author":"Mitsea","year":"2022","unstructured":"Mitsea A,\nPalikaraki G,\nKaramesinis K,\nVastardis H,\nGizani S,\nSifakakis I. Evaluation of lateral incisor resorption caused by impacted maxillary canines based on CBCT: a systematic review and meta-analysis. Children (Basel). 2022;9(7):1006. doi:10.3390\/children9071006"},{"issue":"2","key":"i1945-7103-96-2-181-b03","series-title":"Semin Orthod","first-page":"87","article-title":"Clinical management of impacted maxillary canines","volume":"4","author":"Bishara","year":"1998","unstructured":"Bishara SE. Clinical management of impacted maxillary canines. Semin Orthod. 1998;4(2):87\u201398. doi:10.1016\/s1073-8746(98)80006-6"},{"issue":"4","key":"i1945-7103-96-2-181-b04","series-title":"Br Dent J","first-page":"171","article-title":"National clinical guidelines for management of the palatally ectopic maxillary canine","volume":"213","author":"Husain","year":"2012","unstructured":"Husain J,\nBurden D,\nMcSherry P,\nMorris D,\nAllen M. National clinical guidelines for management of the palatally ectopic maxillary canine. Br Dent J. 2012;213(4):171\u2013176. doi:10.1038\/sj.bdj.2012.726"},{"issue":"5","key":"i1945-7103-96-2-181-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"657","article-title":"Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial","volume":"136","author":"Baccetti","year":"2009","unstructured":"Baccetti T,\nMucedero M,\nLeonardi M,\nCozza P. Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2009;136(5):657\u2013661. doi:10.1016\/j.ajodo.2008.03.019"},{"issue":"7","key":"i1945-7103-96-2-181-b06","series-title":"Int J Oral Maxillofac Surg","first-page":"745","article-title":"Tooth transplantations: a descriptive retrospective study","volume":"34","author":"Kallu","year":"2005","unstructured":"Kallu R,\nVinckier F,\nPolitis C,\nMwalili S,\nWillems G. Tooth transplantations: a descriptive retrospective study. Int J Oral Maxillofac Surg. 2005;34(7):745\u2013755. doi:10.1016\/j.ijom.2005.03.009"},{"issue":"3","key":"i1945-7103-96-2-181-b07","series-title":"Angle Orthod","first-page":"231","article-title":"Long-term results of orthodontic treatment of impacted maxillary canines","volume":"73","author":"D\u2019Amico","year":"2003","unstructured":"D\u2019Amico RM,\nBjerklin K,\nKurol J,\nFalahat B. Long-term results of orthodontic treatment of impacted maxillary canines. Angle Orthod. 2003;73(3):231\u2013238. doi:10.1043\/0003-3219(2003)073<0231:LROOTO>2.0.CO;2"},{"issue":"4","key":"i1945-7103-96-2-181-b08","series-title":"J World Fed Orthod","first-page":"135","article-title":"Orthodontic root resorption","volume":"10","author":"Sameshima","year":"2021","unstructured":"Sameshima GT,\nIglesias-Linares A. Orthodontic root resorption. J World Fed Orthod. 2021;10(4):135\u2013143. doi:10.1016\/j.ejwf.2021.09.003"},{"issue":"2","key":"i1945-7103-96-2-181-b09","series-title":"J Orthod Sci","first-page":"43","article-title":"Risk factors and management of white spot lesions in orthodontics","volume":"2","author":"Srivastava","year":"2013","unstructured":"Srivastava K,\nTikku T,\nKhanna R,\nSachan K. Risk factors and management of white spot lesions in orthodontics. J Orthod Sci. 2013;2(2):43\u201349. doi:10.4103\/2278-0203.115081"},{"issue":"3","key":"i1945-7103-96-2-181-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"191","article-title":"Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents","volume":"96","author":"Boyd","year":"1989","unstructured":"Boyd RL,\nLeggott PJ,\nQuinn RS,\nEakle WS,\nChambers D. Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents. 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Eur J Orthod. 2008;30(4):386\u2013395. doi:10.1093\/ejo\/cjn018"},{"issue":"11","key":"i1945-7103-96-2-181-b13","series-title":"Cureus","first-page":"e31219","article-title":"Comparative evaluation of orthodontically-induced root resorption using cone beam computed tomography (CBCT) and orthopantomogram (OPG) during en-masse retraction of maxillary anterior teeth","volume":"14","author":"Alassiry","year":"2022","unstructured":"Alassiry A. Comparative evaluation of orthodontically-induced root resorption using cone beam computed tomography (CBCT) and orthopantomogram (OPG) during en-masse retraction of maxillary anterior teeth. Cureus. 2022;14(11):e31219. doi:10.7759\/cureus.31219"},{"issue":"1","key":"i1945-7103-96-2-181-b14","series-title":"Eur J Orthod","first-page":"30","article-title":"Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors","volume":"10","author":"Levander","year":"1988","unstructured":"Levander E,\nMalmgren O. Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors. Eur J Orthod. 1988;10(1):30\u201338. doi:10.1093\/ejo\/10.1.30"},{"issue":"3","key":"i1945-7103-96-2-181-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"e141","article-title":"Association between initial complexity, frequency of refinements, treatment duration, and outcome in Invisalign orthodontic treatment","volume":"162","author":"Arqub","year":"2022","unstructured":"Arqub SA,\nBanankhah S,\nSharma R, et al. Association between initial complexity, frequency of refinements, treatment duration, and outcome in Invisalign orthodontic treatment. 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Am J Orthod Dentofacial Orthop. 2018;154(3):375\u2013381. doi:10.1016\/j.ajodo.2017.12.012"},{"issue":"1","key":"i1945-7103-96-2-181-b19","series-title":"J Appl Oral Sci","first-page":"75","article-title":"Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation","volume":"25","author":"Silva","year":"2017","unstructured":"Silva AC da,\nCapistrano A,\nAlmeida-Pedrin RR de,\nCardoso M de A,\nConti AC de CF,\nCapelozza LF. Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation. J Appl Oral Sci. 2017;25(1):75\u201381. doi:10.1590\/1678-77572016-0133"},{"issue":"3","key":"i1945-7103-96-2-181-b20","series-title":"Niger J Clin Pract","first-page":"301","article-title":"Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines","volume":"21","author":"Oz","year":"2018","unstructured":"Oz AZ,\nCiger S. Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines. Niger J Clin Pract. 2018;21(3):301\u2013305. doi:10.4103\/njcp.njcp_419_16"},{"issue":"4","key":"i1945-7103-96-2-181-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"427","article-title":"Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study","volume":"141","author":"Brusveen","year":"2012","unstructured":"Brusveen EMG,\nBrudvik P,\nB\u00f8e OE,\nMavragani M. Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study. Am J Orthod Dentofacial Orthop. 2012;141(4):427\u2013435. doi:10.1016\/j.ajodo.2011.10.022"},{"issue":"1","key":"i1945-7103-96-2-181-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"28","article-title":"Influence of impacted maxillary canine orthodontic traction complexity on root resorption of incisors: a retrospective longitudinal study","volume":"155","author":"Arriola-Guill\u00e9n","year":"2019","unstructured":"Arriola-Guill\u00e9n LE,\nRu\u00edz-Mora GA,\nRodr\u00edguez-C\u00e1rdenas YA,\nAliaga-Del Castillo A,\nBoessio-Vizzotto M,\nDias-Da Silveira HL. Influence of impacted maxillary canine orthodontic traction complexity on root resorption of incisors: a retrospective longitudinal study. Am J Orthod Dentofacial Orthop. 2019;155(1):28\u201339. doi:10.1016\/j.ajodo.2018.02.011"},{"issue":"3","key":"i1945-7103-96-2-181-b01","series-title":"Br J Orthod","first-page":"209","article-title":"The ectopic maxillary canine: a review","volume":"25","author":"McSherry","year":"1998","unstructured":"McSherry PF. The ectopic maxillary canine: a review. Br J Orthod. 1998;25(3):209\u2013216. doi:10.1093\/ortho\/25.3.209"},{"issue":"7","key":"i1945-7103-96-2-181-b02","series-title":"Children (Basel)","first-page":"1006","article-title":"Evaluation of lateral incisor resorption caused by impacted maxillary canines based on CBCT: a systematic review and meta-analysis","volume":"9","author":"Mitsea","year":"2022","unstructured":"Mitsea A,\nPalikaraki G,\nKaramesinis K,\nVastardis H,\nGizani S,\nSifakakis I. Evaluation of lateral incisor resorption caused by impacted maxillary canines based on CBCT: a systematic review and meta-analysis. Children (Basel). 2022;9(7):1006. doi:10.3390\/children9071006"},{"issue":"2","key":"i1945-7103-96-2-181-b03","series-title":"Semin Orthod","first-page":"87","article-title":"Clinical management of impacted maxillary canines","volume":"4","author":"Bishara","year":"1998","unstructured":"Bishara SE. Clinical management of impacted maxillary canines. Semin Orthod. 1998;4(2):87\u201398. doi:10.1016\/s1073-8746(98)80006-6"},{"issue":"4","key":"i1945-7103-96-2-181-b04","series-title":"Br Dent J","first-page":"171","article-title":"National clinical guidelines for management of the palatally ectopic maxillary canine","volume":"213","author":"Husain","year":"2012","unstructured":"Husain J,\nBurden D,\nMcSherry P,\nMorris D,\nAllen M. National clinical guidelines for management of the palatally ectopic maxillary canine. Br Dent J. 2012;213(4):171\u2013176. doi:10.1038\/sj.bdj.2012.726"},{"issue":"5","key":"i1945-7103-96-2-181-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"657","article-title":"Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial","volume":"136","author":"Baccetti","year":"2009","unstructured":"Baccetti T,\nMucedero M,\nLeonardi M,\nCozza P. Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2009;136(5):657\u2013661. doi:10.1016\/j.ajodo.2008.03.019"},{"issue":"7","key":"i1945-7103-96-2-181-b06","series-title":"Int J Oral Maxillofac Surg","first-page":"745","article-title":"Tooth transplantations: a descriptive retrospective study","volume":"34","author":"Kallu","year":"2005","unstructured":"Kallu R,\nVinckier F,\nPolitis C,\nMwalili S,\nWillems G. Tooth transplantations: a descriptive retrospective study. Int J Oral Maxillofac Surg. 2005;34(7):745\u2013755. doi:10.1016\/j.ijom.2005.03.009"},{"issue":"3","key":"i1945-7103-96-2-181-b07","series-title":"Angle Orthod","first-page":"231","article-title":"Long-term results of orthodontic treatment of impacted maxillary canines","volume":"73","author":"D\u2019Amico","year":"2003","unstructured":"D\u2019Amico RM,\nBjerklin K,\nKurol J,\nFalahat B. Long-term results of orthodontic treatment of impacted maxillary canines. Angle Orthod. 2003;73(3):231\u2013238. doi:10.1043\/0003-3219(2003)073<0231:LROOTO>2.0.CO;2"},{"issue":"4","key":"i1945-7103-96-2-181-b08","series-title":"J World Fed Orthod","first-page":"135","article-title":"Orthodontic root resorption","volume":"10","author":"Sameshima","year":"2021","unstructured":"Sameshima GT,\nIglesias-Linares A. Orthodontic root resorption. J World Fed Orthod. 2021;10(4):135\u2013143. doi:10.1016\/j.ejwf.2021.09.003"},{"issue":"2","key":"i1945-7103-96-2-181-b09","series-title":"J Orthod Sci","first-page":"43","article-title":"Risk factors and management of white spot lesions in orthodontics","volume":"2","author":"Srivastava","year":"2013","unstructured":"Srivastava K,\nTikku T,\nKhanna R,\nSachan K. Risk factors and management of white spot lesions in orthodontics. J Orthod Sci. 2013;2(2):43\u201349. doi:10.4103\/2278-0203.115081"},{"issue":"3","key":"i1945-7103-96-2-181-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"191","article-title":"Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents","volume":"96","author":"Boyd","year":"1989","unstructured":"Boyd RL,\nLeggott PJ,\nQuinn RS,\nEakle WS,\nChambers D. Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents. Am J Orthod Dentofacial Orthop. 1989;96(3):191\u2013198. doi:10.1016\/0889-5406(89)90455-1"},{"issue":"6","key":"i1945-7103-96-2-181-b11","series-title":"J Clin Periodontol","first-page":"631","article-title":"Gingival labial recessions in orthodontically treated and untreated individuals: a case-control study","volume":"40","author":"Renkema","year":"2013","unstructured":"Renkema AM,\nFudalej PS,\nRenkema AAP,\nAbbas F,\nBronkhorst E,\nKatsaros C. Gingival labial recessions in orthodontically treated and untreated individuals: a case-control study. J Clin Periodontol. 2013;40(6):631\u2013637. doi:10.1111\/jcpe.12105"},{"issue":"4","key":"i1945-7103-96-2-181-b12","series-title":"Eur J Orthod","first-page":"386","article-title":"Factors affecting the duration of orthodontic treatment: a systematic review","volume":"30","author":"Mavreas","year":"2008","unstructured":"Mavreas D,\nAthanasiou AE. Factors affecting the duration of orthodontic treatment: a systematic review. Eur J Orthod. 2008;30(4):386\u2013395. doi:10.1093\/ejo\/cjn018"},{"issue":"11","key":"i1945-7103-96-2-181-b13","series-title":"Cureus","first-page":"e31219","article-title":"Comparative evaluation of orthodontically-induced root resorption using cone beam computed tomography (CBCT) and orthopantomogram (OPG) during en-masse retraction of maxillary anterior teeth","volume":"14","author":"Alassiry","year":"2022","unstructured":"Alassiry A. Comparative evaluation of orthodontically-induced root resorption using cone beam computed tomography (CBCT) and orthopantomogram (OPG) during en-masse retraction of maxillary anterior teeth. Cureus. 2022;14(11):e31219. doi:10.7759\/cureus.31219"},{"issue":"1","key":"i1945-7103-96-2-181-b14","series-title":"Eur J Orthod","first-page":"30","article-title":"Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors","volume":"10","author":"Levander","year":"1988","unstructured":"Levander E,\nMalmgren O. Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors. 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Factors associated with the duration of forced eruption of impacted maxillary canines: a retrospective study. Am J Orthodont Dentofacial Orthop. 2006;130(3):349\u2013356. doi:10.1016\/j.ajodo.2004.12.028"},{"issue":"3","key":"i1945-7103-96-2-181-b18","series-title":"Am J Orthod Dentofacial Orthop","first-page":"375","article-title":"Effect of orthodontic treatment and comorbidity risk factors on interdental alveolar crest level: a radiographic evaluation","volume":"154","author":"Zoizner","year":"2018","unstructured":"Zoizner R,\nArbel Y,\nYavnai N,\nBecker T,\nBirnboim-Blau G. Effect of orthodontic treatment and comorbidity risk factors on interdental alveolar crest level: a radiographic evaluation. Am J Orthod Dentofacial Orthop. 2018;154(3):375\u2013381. doi:10.1016\/j.ajodo.2017.12.012"},{"issue":"1","key":"i1945-7103-96-2-181-b19","series-title":"J Appl Oral Sci","first-page":"75","article-title":"Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation","volume":"25","author":"Silva","year":"2017","unstructured":"Silva AC da,\nCapistrano A,\nAlmeida-Pedrin RR de,\nCardoso M de A,\nConti AC de CF,\nCapelozza LF. Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation. J Appl Oral Sci. 2017;25(1):75\u201381. doi:10.1590\/1678-77572016-0133"},{"issue":"3","key":"i1945-7103-96-2-181-b20","series-title":"Niger J Clin Pract","first-page":"301","article-title":"Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines","volume":"21","author":"Oz","year":"2018","unstructured":"Oz AZ,\nCiger S. Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines. Niger J Clin Pract. 2018;21(3):301\u2013305. doi:10.4103\/njcp.njcp_419_16"},{"issue":"4","key":"i1945-7103-96-2-181-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"427","article-title":"Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study","volume":"141","author":"Brusveen","year":"2012","unstructured":"Brusveen EMG,\nBrudvik P,\nB\u00f8e OE,\nMavragani M. Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study. Am J Orthod Dentofacial Orthop. 2012;141(4):427\u2013435. doi:10.1016\/j.ajodo.2011.10.022"},{"issue":"1","key":"i1945-7103-96-2-181-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"28","article-title":"Influence of impacted maxillary canine orthodontic traction complexity on root resorption of incisors: a retrospective longitudinal study","volume":"155","author":"Arriola-Guill\u00e9n","year":"2019","unstructured":"Arriola-Guill\u00e9n LE,\nRu\u00edz-Mora GA,\nRodr\u00edguez-C\u00e1rdenas YA,\nAliaga-Del Castillo A,\nBoessio-Vizzotto M,\nDias-Da Silveira HL. Influence of impacted maxillary canine orthodontic traction complexity on root resorption of incisors: a retrospective longitudinal study. 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