The impact of orthodontic space closure and subsequent canine substitution of bilateral congenitally absence of maxillary lateral incisors on the oral health-related quality of life

Abstract

Background: Closure of the space of missing maxillary lateral incisors and canine substitution is probably the first choice to avoid long-term restorative replacements but may produce an inferior aesthetic result which may has adverse effect on oral health. Aims: To assess the effects of orthodontic space closure (OSC) of bilateral congenitally absence of maxillary lateral incisors (CMMLI) and consequent canine substitution on Oral Health-Related Quality of Life (OHRQL). Materials and Methods: The impacts of OSC and canine substitution on the OHRQL were assessed using the short-version of the Oral Health Impact Profile (OHIP) and a modified version of the Eastman Esthetic Index (EEI) questionnaires. Answers of the patients’ perception to esthetics of the tooth substitution were rated and correlated between gender and compared between the oral health and esthetic perception categories. Results: Females had higher mean OHIP score in all domains and lower mean EEI score than males. Overall, 76% of patients rated their oral health as satisfactory, more males were satisfied than females. Significantly, 33.3% of females recorded impacts to their oral health compared to 20% of males (P=0.014). More males (p=0.049) were dissatisfied with the colour, and more females (p=0.022) were dissatisfied with the shape. The most common impacts were related to social disability domain in the perception of male patients to colour of teeth (p=0.00078) and in Psychological discomfort and disability domains in females with poor perception to the shape and size of teeth, respectively. Conclusions: One-fourth of patients were associated with impairment in OHRQL, this extent and severity appeared to be expressed by social disability and psychological discomfort. Keywords: Canine substitution, Congenitally absence of maxillary lateral incisors, Eastman Esthetic Index, Oral Health Impact Profile, Oral Health Related Quality of life, Orthodontic space closure, O