Palatally displaced canines and the importance of economic outcomes: A narrative review

Abstract

The escalating costs of healthcare on a global scale have underscored the need for cost-effective treatment strategies, including those in the domain of orthodontic care. Despite orthodontics constituting a modest proportion of tax-funded healthcare systems, such as in Sweden or the UK, the need to evaluate treatment value remains paramount, irrespective of how healthcare is paid for. This review examined the economic evaluations of surgical techniques used for managing palatally displaced canines (PDCs)—a complex orthodontic issue that often requires surgery and prolonged treatment. The findings of included studies indicated that there were no statistically significant differences in surgical time or total orthodontic treatment duration between the two techniques. However, a cost-minimization analysis performed on a single study revealed that the societal cost was marginally lower for open exposure ($7035) than for closed exposure ($7434), with a difference of $399. This discrepancy, however, did not attain statistical significance. While both techniques were clinically effective, open exposure with spontaneous eruption demonstrated a modest cost advantage in one trial, largely due to a reduction in early-phase orthodontic visits. The current economic evaluations are limited in number and quality, and further high-quality trials are required to improve generalisability and inform decision-making.