Comparison of patients' and orthodontists' perception on the orthodontic treatment outcome using Maxillary Canine Aesthetic Index

The aim of this study was to evaluate the treatment outcome of a previously impacted canine from the patients’ perspective and to compare it with an objective assessment by a panel of orthodontists. An additional objective was to test the influence of the initial position of the canine on the treatment outcome. The study sample consisted of 28 patients from a previous study who agreed to fill a questioner regarding the treatment outcome. Clinical photographs of the cases were assessed by three orthodontists using MCAI (Maxillary Canine Aesthetic Index). The treatment outcome was associated with the initial position of the canine assessed on the cone beam computed tomography. Thirteen patients (46%) could not see any differences between the previously treated and the contralateral canine, while the orthodontists noticed the differences in 23 (82%). The difference was significant (p = 0.005). The patients were less critical about the aesthetic appearance of the previously impacted canines as compared to the orthodontists. But these differences were not significant, except for the mesiodistal angulation, where the patients noticed the difference only in one case, while the orthodontists identified differences in six cases (p = 0.043). The orthodontists were able to detect the differences in the gingival height and root inclination and that was reflected in the higher Maxillary Canine Aesthetic Indices. The treatment outcome was insignificantly influenced by the initial position of the canine. The orthodontists were more critical than patients concerning the treatment-related outcome. The Maxillary Canine Aesthetic Index can be used for professional assessment, but it reflects the patient’s perspective to a lesser extent.