Early management of displaced maxillary canines: Extractions and dentoalveolar expansion with clear aligners

Objective: To assess the interceptive effectiveness of clear aligners combined with the extraction of the primary canines (C) and first primary molars (D) in promoting the spontaneous eruption of displaced maxillary canines (DMCs) in growing patients during early mixed dentition. Methods: This retrospective study analyzed 14 growing patients (mean age 8.4 ± 1.5 years) with early DMCs, all treated with clear aligners and extractions of teeth C and D. The sample was compared to a matched control group of 14 patients treated with rapid maxillary expansion (RME) and the same extraction protocol. Panoramic radiographs (OPT) were analyzed at baseline (T1, pre-treatment) and at the end of the active phase of treatment (T2). On these radiographs, angular (α, β, π, η) and linear (distance D) measurements were performed. Descriptive and comparative statistical analyses were conducted both within and between groups, with the significance level set at 0.05. Results: In the clear aligner group, all angular (α, β, π, η) and linear (distance D) variables showed statistically significant differences between T1 and T2 (p < 0.05). No statistically significant differences were observed between the clear aligner and control groups at T1 (starting forms) or in the comparison of changes between T2 and T1. Conclusions: Clear aligners combined with the extraction of C and D proved to be an effective interceptive approach for improving the intraosseous position of displaced maxillary canines in early mixed dentition.