Minimally invasive orthodontic management: a paradigm shift in interceptive care. Part I – concept and palatally displaced canines

Abstract

Introduction: Conservative approaches in childhood may enhance esthetics and function while reducing the likelihood of complex Phase II orthodontic treatments during adolescence. Objective: This article aims to introduce the principles of Minimally Invasive Orthodontic Management (MIO) during the mixed dentition period, promoting the concept of "as little intervention as possible", in accordance to The "Orange July" campaign. Methods: The core principles of MIO include: (1) early diagnosis and risk assessment; (2) evidence-based, timely, and targeted interventions; and (3) prioritization of patient comfort and psychosocial well-being. Part I addresses the application of MIO to the interceptive management of palatally displaced canines (PDC). Early diagnosis, typically between ages 10 and 12, is based on clinical indicators and radiographic assessment. Major risk factors for PDC include female sex, hypodivergent facial growth pattern, dental spacing, and the presence of associated dental anomalies. Interceptive strategies such as the extraction of the deciduous canine, associated with a success rate of approximately 70%, and adjunctive treatments like rapid maxillary expansion or cervical headgear in Class II patients have demonstrated positive outcomes. Results: These minimally invasive protocols contribute to simplify Phase II treatment, reducing the risk of maxillary incisor root resorption and improving cost-effectiveness. Conclusion: The "Orange July" campaign reinforces the importance of early orthodontic evaluation and supports the MIO model as a biologically sound, patient-centered approach to managing developing malocclusions during the mixed dentition phase.