Ectopic maxillary canines and root resorption of adjacent incisors. Does computed tomography (CT) influence decision-making by orthodontists?

Abstract

The purpose of this investigation was to evaluate whether access to computed tomography (CT) influences orthodontists' decision-making about management of incisor root resorption due to ectopic maxillary canines. The study base comprised orthodontic specialists and active members of the Swedish Orthodontic Society: 182 orthodontists under 65 years of age, who had been registered specialists for at least one year and were providing specialist treatment for regular orthodontic patients. A questionnaire was sent out, comprising 8 questions about management and decision-making in cases of ectopic maxillary canines with root resorption of adjacent incisors and 7 questions about practice profile. The orthodontists were asked whether they altered their treatment decisions when CT was available as a diagnostic tool. The response rate was high, 86%. Sixty of the orthodontists had access to CT. Sixty-one percent of the 97 orthodontists without access to CT stated that, in cases with space deficiency, they seldom or never considered extraction of a lateral incisor with suspected root resorption if the resorption was not discernible on intra-oral or panoramic radiographs. It was evident that even in cases of root resorption of lateral incisors due to ectopic canines,the orthodontists' management decisions were not particularly influenced by availability of CT diagnostic data. In the extraction cases 55% of the orthodontists considered extraction of the affected incisor first when root resorption was severe, i.e. involving the pulp and 37% when the resorption reached half way to the pulp. In cases without space deficiency 82% preferred to extract these resorbed lateral incisors not until the resorption reached the pulp.