Knowledge and Preference of Prosthodontic and Orthodontic Treatment Options for Dental Anomalies among General Practitioners in India

Piyush Gupta^1*, Sourav Kumar Pati², Kavuda Nagarjuna Prasad¹, Saranya S¹, Rachita Guru¹ and Bikash Ranjan Bindhani¹

^*Correspondence: Piyush Gupta, Department of Orthodontics and DentofacialOrthopaedics, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Odisha, India, Email:

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Introduction

A peg lateral can be defined as an undersized, tapered, maxillary lateral incisor. Other anomalies can also be associated with it like over retained deciduous teeth or canine transposition etc. The peg-shaped lateral incisor is one that has an incisalmesiodistal width of the tooth crown shorter than the cervical width. This can lead to aesthetic, function and periodontal problems for the patient. Whenever there is malformed maxillary lateral incisor, the individual also has midline diastema which results due to distal migration of central incisor. Due the reduced size of lateral incisors, formation of other diastema is also more likely to take place. Normally, such patients exhibit an otherwise normal dentition. Prevalence of peg shaped lateral incisor has been much more than the prevalence of any other developmental disturbance in the oral cavity. The prevalence of peg-shaped maxillary permanent lateral incisors varies by race, population type, and sex [1]. It has always been a challenge for prosthodontists and orthodontists to treat a young patient with anterior spaces and/or presence of peg shaped lateral incisor. To resolve this problem, generally speaking there are two principal approaches. First approach aims at maintenance of spaces for future auto transplantation or restoring with prosthodontic approach if extraction is planned. The alternative way is to close the spaces orthodontically and then restoration of peg lateral by prosthetic central incisor. Each of these approaches has its own advantages and disadvantages and the prevailing conditions also influence the type of treatment plan or approach. Decisions to choose an approach are based on several factors such as type of existing occlusion, space conditions, width of lateral incisor and its root length, the shape and shade of canine, position of canine etc. Apart from this the type of treatment should also be selected based on esthetic and functional requirements, need for extractions and potential for coordinating prosthodontic and orthodontic treatment[1-3]. The development of acidetch technique and new adhesive systems has been a boon to the restorative dentistry. And it provides us with an alternative of adopting integrated approach for management of space closure and restoration of peg lateral in a most satisfactory manner. Because the results rarely are satisfactory when a single approach i.e. prosthodontic or orthodontic alone is adopted. The aims and objectives of this study are to conduct a survey using questionnaire to evaluate the knowledge and awareness of Saudi general practitioners regarding needs of prosthodontic, orthodontic, or integrated treatment approach for management of peg shaped lateral incisor.

Methodology

A Cross-sectional study was planned to conduct a survey using questionnaire containing 16 questions which were mailed and distributed through the local dental association data base to random.1000 general dental surgeons who voluntarily took part in the study. Pattern of questionnaire was as mentioned below and the response to the survey was recorded and analyzed electronically.

Results

Data record and analysis was done electronically and results of the questionnaire were selfexplanatory. Starting with the 1st question, 50.5% were females who took part tin survey. 60% of total responders were fresh who were in practice since less than 5 years. 52% responders were in need of services of both orthodontist and prosthodontist for the management of peg lateral incisors (Table 1, 2). Almost 40% responders do the diagnostic wax up in such cases. 43.2% responders decided to plan prosthetic treatment after completion of orthodontic treatment and for that full coverage crown was the most preferred choice for rehabilitation in regard question 6, 7 and 8. Single tooth implant was the choice of the treatment when peg lateral tooth was planned extraction in search of maximum esthetic outcome and for that width and height of the bone was the most important factor to be considered according to responders. 91% of responders believed that combination of both orthodontic and prosthodontic approach was best to achieve the perfect treatment outcome. Long treatment time was the biggest factor of dissatisfaction after interdisciplinary approach for the management of peg lateral incisor. 43.1% of responders didn’t find any difficulty in communication with the specialist.