Post-treatment aesthetic outcomes in palatally displaced canines exposed by open versus closed surgical technique: A prospective cohort study and a survey.

BACKGROUND

The multidisciplinary treatment of palatally displaced canines (PDCs) involves choosing between open and closed surgical exposure.

AIM: To compare post-treatment aesthetic outcomes between PDC exposed by open and by closed surgical exposure.

METHODS

A digital survey was distributed to two respondent groups - orthodontists and laypeople - to evaluate PDC post-treatment appearance outcomes. The survey featured 62 series of three intra-oral post-treatment images taken at debonding and four years later, with 31 PDC cases per surgical exposure group. Patients were on average 13 years old at time of surgical exposure and were part of a multicentre RCT comparing clinical outcomes between the two exposure techniques. Both surgical exposure methods involved mucoperiosteal flaps and bone removal above the PDCs.

RESULTS

The respondent groups' ability to identify surgically exposed canines, as well as the ratings of "unexposed looking better than exposed canine," achieved proportions below chance. Orthodontists demonstrated better identification ability than laypeople (P=0.013), with higher odds of correctly identifying exposed canines, odds ratio (OR) of 3.2 (95% CI 1.5-7.1, P=0.003) and rating "better-looking unexposed contralateral canines" in open exposure compared to closed exposure technique, OR of 4.3 (95% CI 1.8-10.2, P=0.001).

CONCLUSIONS

The results support free preference in choosing surgical exposure methods, indicating that aesthetic factors are not the main consideration in clinical practice. However, orthodontists found the PDCs treated with the closed technique more appealing.

CLINICAL TRIAL REGISTRATION: Researchweb.org, ID: 278893.