Combined orthodontic and surgical approaches in the treatment of impacted teeth

Abstract

Impacted teeth are one of the most complex challenges in orthodontics, requiring accurate three-dimen- sional diagnosis and careful biomechanical planning. Aim and purpose: To review and analyze orthodontic strategies for the management of impacted teeth in children and adults, including biomechanical, surgical approaches and combinations of fixed and re- movable appliances, to ensure controlled, functional and aesthetic eruption. Methodology: A clinical analysis of an orthodontic case with impacted teeth, treated with advanced orthodontic and surgical protocols, was performed in the Albanian University, dental clinic. Also, a liter- ature review was conducted according to the PRISMA 2020 protocol, including searches in international scientific databases such as: PubMed, Scopus, Web of Science for the period 2015–2025. Results: Skeletal anchorage with TAD and modified TADMAN/Beneslider appliances provided maxi- mum control over the force vector, sustained distalization, and elimination of adverse effects in the ante- rior segment. Conclusions: Treatment of impacted teeth requires accurate three-dimensional diagnosis, individual - ized biomechanical planning, and integration of modern anchorage and surgical exposure methods. RPE, TADs, Beneslider, and minimally invasive exposure techniques were found to be effective and safe in the management of complex impaction cases. The combined orthodontic–surgical approach provided con - trolled eruption, periodontal stability, and long-term functional and aesthetic results.