Open vs closed exposure of palatally displaced canines: clinical, patient-related outcomes and health economics

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Fältnamn	Indikatorer	Metadata
000		04369nam a2200361 4500
001		oai:DiVA.org:oru-90894
003		SwePub
008		210407s2021 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
020		a 9789175293950q print
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-908942 URI
040		a (SwePub)oru
041		a engb eng
042		9 SwePub
072	7	a vet2 swepub-contenttype
072	7	a dok2 swepub-publicationtype
100	1	a Björksved, Margitha,d 1964-u Örebro universitet,Institutionen för medicinska vetenskaper4 aut0 (Swepub:oru)mabd
245	1 0	a Open vs closed exposure of palatally displaced canines :b clinical, patient-related outcomes and health economics
264	1	a Örebro :b Örebro University,c 2021
300		a 124 s.
338		a print2 rdacarrier
490	0	a Örebro Studies in Medicine,x 1652-4063 ;v 244
520		a The maxillary permanent canine usually erupts in the mouth between the ages of 11 and 12 years. Sometimes the canines are displaced toward the palatal side of the dental arch and eruption is disturbed. Palatally displaced canines (PDCs) are a frequent dental anomaly, present in 2% of the young population. If untreated, there is risk of damage to the roots of the adjacent teeth and potential tooth loss. Thus, early interceptive treatment with extraction of the deciduous canine should be undertaken, with the aim to improve the PDC eruption path. If the eruption path does not improve within about a year, surgical exposure and orthodontic treatment is indicated.The two different main techniques of surgical exposure in PDCs are the open and the closed techniques. Retrospective studies of the exposure techniques have shown differences in outcomes, which high-lights the need for evidence-based research.The overall aim of this thesis was to compare outcomes of treatment duration, complications and side effects, patients’ perceptions and health economic aspects of the two surgical techniques, in PDCs. Moreover, a comparison of PDC position between the two radiographic methods commonly used in PDC cases; panoramic radiograph and CBCT, aimed to evaluate agreement between the actual measures. This thesis was based on a multicentre randomised controlled trial with two parallel groups, including 120 consecutive patients, aged 9 to 16 years, who were randomly allocated to open or closed surgical exposure. The following conclusions were drawn:The agreement of PDC mesiodistal position was fair (weighted kappa 0.36 (95%CI0.24–0.49) and the mean difference in angle to midline was almost 7˚ (95%CI 5.9˚–7.9˚) higher in panoramic radiographs compared with CBCT. Surgery time, treatment time, root resorption or periodontal measures showed no clinically significant differences between the exposure groups. The open group reported higher pain intensity up to one week post surgery. A higher proportion of bilateral open group cases experienced complications, and weremore frequently wakened at night post surgery. The closed group reported higher pain and discomfort during the orthodontic traction. All PDCs were successfully aligned in the dental arch. A cost-minimization analysis showed no differences in healthcare or societal costs.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
700	1	a Bazargani, Farhan,c docent,d 1969-u Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län4 ths0 (Swepub:oru)fbi
700	1	a Lindsten, Rune,c docentu Centre for Oral Health, School of Health and Welfare, Jönköping University, Sweden4 ths
700	1	a Arnrup, Kristina,c docent,d 1956-u Örebro universitet,Institutionen för hälsovetenskaper4 ths0 (Swepub:oru)kap
700	1	a Sandler, Jonathan,c professoru University of Sheffield, United Kingdom4 opn
710	2	a Örebro universitetb Institutionen för medicinska vetenskaper4 org
856	4	u https://oru.diva-portal.org/smash/get/diva2:1542325/PREVIEW01.pngx Previewy preview image
856	4	u https://oru.diva-portal.org/smash/get/diva2:1542325/COVER01.pdfy cover
856	4	u https://oru.diva-portal.org/smash/get/diva2:1542325/SPIKBLAD01.pdfy spikblad
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-90894

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