Treatment decision analysis for palatally-displaced canines based on orthodontists’ opinion and CBCT

Abstract

The aim of this study was to assess difficulty of treatment of palatally-displaced canines (PDC) according to experts' opinion using CBCT data and to determine a cut-off point for extraction versus forced eruption. Seven CBCT variables of thirty PDC cases were measured with Dolphin 3D software. In addition to measurements of each case, nine 3D and 2D views were prepared on one page and uploaded on the website (canineimpaction.com). Thirty-four orthodontists were asked to judge the difficulty of bringing the impacted canine into occlusal plane. Then, they scored from 1 to 5 the effect of each variable on treatment difficulty and also decided whether to force-erupt or extract the impacted tooth. Overlap in frontal view, angulation of the canine to the occlusal plan, vertical distance to the occlusal plane, age, dilaceration and rotation had significant relationship with the level of treatment difficulty. The treatment plan decision for PDC with treatment difficulty>7.5 was extraction rather than forced eruption. We can predict treatment difficulty of PDC by measuring CBCT variables and decide to extract or force-erupt with a reasonable level of agreement among a panel of orthodontists.