Timing of treatment and the concept of urgency in orthodontics. Guidelines and review of the literature

Objectives. The objective of the study is to define the optimal timing of "urgent" orthodontic treatment of malocclusions. Materials and methods. We conducted a systematic review of the literature that contained quantitative and qualitative data on the timing of orthodontic treatment of various types of malocclusions. Our analysis centered on articles indexed in the Medline database that had been published from 1970 through November 2010, including review articles, meta-analyses, and randomized and controlled clinical trials (RCT and CCT). Results and conclusions. Our analysis of the literature indicates that there are "urgent" orthodontic problems that require prompt treatment, even if the permanent teeth have not erupted. These cases include crossbites, skeletal class III malocclusion, certain behavioral anomalies, the presence of obstacles to eruption or supernumerary teeth, and early tooth shedding. In these cases, early treatment often prevents the later development of severe, frequently skeletal malocclusions. © 2011 Elsevier Srl.