Successful management of severe pediatric cervical trauma emphasizing the role of surgical stabilization and intensive rehabilitation in achieving complete recovery: a case report
Abstract
When protruding upper front teeth are treated with fixed orthodontic appliances, orthodontists often extract the upper first premolars and then retract the front teeth to improve the bite and facial appearance. During this stage, the incisors may tip backward more than desired, which can affect both function and aesthetics. Several orthodontic techniques have been developed to better control this tooth movement. This study combined the results of the best available randomized clinical trials to compare different methods of controlling upper incisor inclination during tooth retraction. Twenty studies involving 568 patients were included. The findings showed that all retraction techniques caused the upper incisors to tip backward to some extent. Loop-based mechanics produced slightly greater backward tipping than sliding mechanics, but the difference was small and unlikely to be clinically important. In addition, no clear advantage was found for retracting all front teeth together compared with retracting the canines first and the incisors later. Overall, the results suggest that successful control of incisor inclination depends not only on the choice of retraction technique but also on careful treatment planning and appropriate biomechanical adjustments throughout orthodontic treatment.