Non-metric trait “winging” in dental malocclusion: A scoping review

Abstract

ackground: Dental non-metric and metric traits provide valuable evidence in anthropology and ethnicity determina????on in forensics. Of the various non-metric dental traits, “winging” and “counter-winging” represent the rota????on of upper incisors, described by various authors, and are known to be influenced by gene-environment interplay. Thus, it shows associa????on to various dental and skeletal classes of malocclusion which may have anthropological and clinical implica????ons. Material and methods: The current scoping review was planned with the aim to study skeletal and dental malocclusions associated to “winging”. A thorough literature search was conducted in June 2023 in ‘PubMed’, ‘Scopus’ and ‘Web of Science” with MeSH and free text terms, “winging”, “orthodon????cs” in combina????on with Boolean terminologies. Study designs including clinical trials, case series, and case reports were included with no limita????on of date and language. Ini????al search was done with a pre-determined search strategy, followed by duplicate removal, further exclusion by strict inclusion criteria, and full text retrieval of final included records. Results: PRISMA revealed 47 records in ini????al search, followed exclusion of 43 records, and final inclusion of 4 ar????cles where orthodon????c interven????on had been a????empted for correc????on of winged maxillary incisors. All studies had a????empted derota ????on of winging successfully, of which one of the studies intervened with aligner therapy, and the other three with sec????onal fixed orthodon????c appliances. Of these, one case report on a cle???? pa????ent men????oned a 6-year reten????on follow-up. Discussion and conclusion: Winging represents an unusual dental morphological pa????ern in an individual and is frequently associated with dental/skeletal malocclusions and growth abnormali????es like cle???? lip and palate, as has been presented in the current scoping review. It also highlights the challenges in management of winging in orthodon????c correc????on and the requirement of long-term reten????on in such cases. This review brings forth the need to explore further the gene????c overlap of winging with other dental and skeletal traits. Also, “winging” should be documented as a separate malocclusion trait in regular orthodon????c assessments with a huge poten????al in individual iden????fica????on in forensics.