The impact of orthodontic traction on outcomes in impacted canine management: a quantitative analysis.

Objective: 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. Materials and Methods: 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 U-test, Wilcoxon signed-rank test, χ2 test, and Cochran's Q test, with significance set at P < .05. Results: The impaction group had significantly longer treatment duration (mean = 2.64 ± 0.99 years) than controls (mean = 1.85 ± 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 (P < .05). WSL incidence was higher in the impaction group, especially in posterior teeth (P = .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. Conclusions: 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.