Palatally displaced and impacted canines – What is taught during postgraduate orthodontics training in Europe?

Abstract

Objectives: One of the most challenging orthodontic treatments is displaced and impacted canines palatally displaced canines (PDC/PIC). The aim of this study was, therefore, to assess what postgraduate students are taught about PDC and PIC during their postgraduate orthodontic training (POT) in Europe. Materials and Methods: A digital survey containing 22 questions was sent to 164 POT programs in 28 European countries. Questions were asked about which interceptive and surgical treatments are taught, the advantages of different surgical procedures, and what dressing materials and X-rays are used for PIC therapy planning. Reminders were sent 4 times. Results: About 43% (71 POT programs) responded. Extraction of deciduous canines (76%) was the most favored interceptive treatment. A closed technique with a gingival margin flap and a gold plated chain was the most commonly taught surgical technique (69%), even though both open and closed exposure of PICs were performed in 54 postgraduate programs. Coe-Pak™ with sutures was one of the preferred dressing materials in open exposure. Active treatment was started before the canine erupted, that is, spontaneous eruption of the tooth following open exposure was not awaited by 1/3 of the respondents and 1/3 left the question unanswered. Closed exposure was more often preferred than open exposure for post-surgical, periodontal, and esthetic reasons. The most common radiographs before surgery were panoramic and intraoral radiographs. Cone-beam computed tomography was taken by half of the respondents when resorption of adjacent teeth was suspected. Conclusion: Extraction of deciduous canines as an interceptive approach to PDC and closed exposure of PIC were taught in most of the POT programs.