title: Esthetic judgments of palatally displaced canines 3 months postdebond after surgical exposure with either a closed or an open technique.
abstract: BACKGROUND
  The aim of this study was to compare the esthetic judgments of orthodontists and laypeople regarding the appearance of palatally displaced canines 3 months after treatment with either a closed or an open surgical exposure and orthodontic alignment.
  
  
  METHODS
  A multicenter randomized controlled trial was undertaken in 3 hospitals in the United Kingdom. Patients with unilateral palatally displaced canines were randomly allocated to receive either a closed or an open surgical exposure. The teeth were aligned with fixed appliances, and 3 months after debond, intraoral photographs were taken. The photographs were projected in random order to 2 panels of judges (orthodontists and laypeople), who completed a questionnaire.
  
  
  RESULTS
  The images of 67 participants (closed, 33; open, 34) were included. The laypeople were able to identify the operated tooth only 49.7% of the time (95% CI, 45.3%-54.0%); this was no better than chance (P = 0.880). The orthodontists were more successful but still identified the treated canine with certainty only 60.7% of the time (95% CI, 53.7%-67.8%; P = 0.003). Both panels more frequently assessed the unoperated canine to have a better appearance than the contralateral operated canine; however, there were no differences between the closed and open groups (proportion preferring unoperated canine-laypeople: closed, 58.7%; open, 57.0%; P = 0.43; and orthodontists: closed, 60.9%; open, 60.6%; P = 0.27).
  
  
  CONCLUSIONS
  There is an esthetic impact to aligning a palatally displaced canine, but it is mostly minor and unlikely to be detectable by laypeople. The esthetic impact was the same, whether the canine was exposed with a closed or an open surgical technique.
authors: Consultant orthodontist, Charles Clifford Dental Hospital, Sheffield, and Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom.
authors: Nicola A
authors: NA
authors: Parkin
authors: Associate professor, Division of Biostatistics, The Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom.
authors: Jennifer V
authors: JV
authors: Freeman
authors: Professor and honorary consultant, paediatric dentistry, Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
authors: Chris
authors: C
authors: Deery
authors: Reader and honorary consultant, orthodontics, Academic Unit of Oral Health and Development, School of Clinical Dentistry, Claremont Crescent, Sheffield, United Kingdom. Electronic address: p.benson@sheffield.ac.uk.
authors: Philip E
authors: PE
authors: Benson
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003481:Cuspid / Q000473:pathology* / Q000601:surgery; D003815:Dentists / Q000523:psychology; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000033:anatomy & histology; D006801:Humans; D007600:Judgment; D008297:Male; D009970:Orthodontics; D023861:Photography, Dental / Q000379:methods; D019228:Tooth Crown / Q000033:anatomy & histology; D014079:Tooth Eruption, Ectopic / Q000601:surgery / Q000628:therapy*; D014087:Tooth Movement Techniques / Q000295:instrumentation / Q000379:methods; D064232:Visual Analog Scale