Severity and Treatment Difficulty of Impacted Maxillary Canine among Orthodontic Patients in Riyadh, Saudi Arabia.

BACKGROUND: The current study aimed to evaluate the severity and treatment difficulty of impacted maxillary canines and their relationship with gender, age group, and bucco-palatal position. METHODS: A retrospective cross-sectional study was conducted from 2017 to 2021. Patients' data and panoramic radiography were obtained from the orthodontic clinic at King Saud University's Dental University Hospital in Riyadh, Saudi Arabia. The severity factors and treatment difficulty index were used to assess the impacted maxillary canines. Statistical analyses were performed utilizing a chi-square test for categorical variables and an independent t-test for numerical variables, and a p-value of ≤0.05. RESULTS: There were 171 impacted maxillary canines in total, with a female-to-male subject ratio (11:8) and a mean age (18.7 years). Overall, 77.2% of impacted upper canines were found to be palatal. The severity of canine impaction parameters showed no significant sex or age group predilection. Buccally impacted maxillary canines were characterized by a preferable angulation to the midline, compared to the palatally impacted maxillary canines (p = 0.012). The horizontal overlap of the impacted maxillary canine cusp tip revealed a significant association with the bucco-palatal position of the impacted canine (p < 0.001). Palatal impaction was located more frequently in sectors 3 and 4. Male patients were found to have a higher total score in terms of the treatment difficulty index relative to females (p = 0.046). CONCLUSION: Despite the severity parameters having revealed no significant gender predilection, males were found to have higher treatment difficulty in maxillary canine impaction than females. The severity of the palatally impacted canine is greater than that of buccal impaction in terms of angulation to the midline and horizontal overlap.

Fixed orthodontic appliance impact on oral health-related quality of life during initial stages of treatment.

AIMS: Our study aimed to assess the oral health-related quality of life (OHRQoL) changes during the initial stage of fixed orthodontic appliance therapy and determined the impact of various orthodontic therapy needs on the OHRQoL of Saudi patients seeking orthodontic treatment. MATERIALS AND METHODS: Forty-two patients aged 14-24 years (69% females) were recruited from the orthodontic clinics. OHRQoL was quantified by a self-administered short version of oral health impact profile (OHIP-14) questionnaire used before treatment (T0) and following bonding of fixed appliance on days 1 (T1), 7 (T2), 14 (T3), and 30 (T4). The higher the OHIP-14 score, the poorer the OHRQoL. The dental health component (DHC) of the index of orthodontic treatment needs (IOTN) was used to assess malocclusion severity. The missing, overjet, crossbite, displacement, overbite (MOCDO) hierarchical scale was used to categorize the most severe feature in each patient and determine the grade of orthodontic treatment need. Changes of OHRQoL over time were compared using the Friedman test. RESULT: Overall OHIP-14 score significantly increased following orthodontic appliance bonding at T1 and T2 compared to T0 (P < 0.001). The functional limitation domains in OHIP-14 pain and discomfort, physical disability, psychological disability, and psychological discomfort were affected at T1 compared to T0 (P < 0.05). Grade 4 IOTN-DHC (definite treatment needs) significantly influenced most OHIP-14 domains compared to other grades. CONCLUSION: With the growing therapeutic and cosmetic demands of orthodontic treatment and the focus on OHRQoL, the study findings can be used to enhance patients' cooperation, expectation, and adherence to orthodontic treatment.

Association of sella turcica bridging with palatal canine impaction in skeletal Class I and Class II.

PURPOSE: Based on the evidence of the embryonic origin of the sella turcica and the teeth, this retrospective study evaluated the association between sella turcica bridging and palatal canine impaction in skeletal Class I and Class II orthodontic patients. METHODS: Sixty-two orthodontic patients with palatally impacted canines and 54 controls with erupted canines (aged 12-25 years) were classified into skeletal Class I and Class II (according to ANB angle and Wits analysis). The length, depth, and diameter of the sella turcica were measured, and the shape was described. The difference in linear dimensions between the study and control groups was calculated using two-way analysis of variance and Student's t-test. The interrelationship of the variables, subject groups, skeletal type, and age, with the linear dimensions of sella turcica, was tested using regression analyses. The association between sella turcica, bridging and palatally impacted canines was determined in skeletal type using a chi-square test. RESULTS: Highly significant differences were found in the length, diameter, and depth of the sella turcica between the study sample and the control (P<0.001, P=0.015, P<0.0001, respectively). There was a highly significant frequency of bridging in cases with palatally impacted canines (P<0.0001). An increasing incidence of bridging was found in subjects with palatally impacted canines and skeletal Class I (P<0.0001) and Class II (P=0.044) relationships. Regression analysis showed that the age was significantly related to a change in length (P=0.025), diameter (P<0.0001), and depth (P<0.0001). The normal sella turcica morphology was present in most subjects (56.4%), and no significant association was found in subjects with palatally impacted canines in terms of the shape of the sella turcica. CONCLUSION: Sella turcica bridging is frequently seen in patients with impacted canines. The findings suggest that careful monitoring of canine eruption is required in patients diagnosed with sella turcica bridging at an early age.