To explore whether there were any differences in orthodontic treatment need, treatment complexity, treatment time, or the number of visits between a group of children receiving early intervention (extraction of upper and lower deciduous canines) and an age- and condition-matched control group without intervention.

Materials and Methods

Patient records and study casts in the late mixed or early permanent dentitions of 46 subjects (20 from the extraction group and 26 from the control group) of an earlier prospective longitudinal study were retrieved. Orthodontic treatment need and complexity were assessed by the index of complexity, outcome, and need (ICON). Statistical calculations were performed by t-test for parametric outcome variables (treatment time, number of visits, and orthodontic treatment need) and Fisher exact test for the categorical variable (tooth extractions).


There were no statistically significant differences between the groups in ICON scores of orthodontic treatment need (extraction group, mean score 59.8; control group, mean score 52.8), number of visits (mean of about 15 visits for both groups), or treatment time (extraction group, mean 21.5 months; control group, mean 20.3 months). The extraction of permanent teeth was more prevalent in the deciduous canine extraction group (59%) as compared with the control group (28%); however, this was not statistically significant (P = .07) but showed a tendency toward worsening the crowding and the future need of orthodontic extractions.


Early removal of deciduous primary canines will reduce neither the need for later orthodontic treatment nor its complexity, nor will it shorten the treatment time.

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Author notes


Specialist in Orthodontics, Orthodontic and Pediatric Section, Dental Department, King Fahad Medical City, Riyadh, Saudi Arabia; and Division of Orthodontics, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.


Specialist in Orthodontics, Department of Preventive Dentistry, College of Dentistry, University of Hail, Hail, Saudi Arabia; and Orthodontic Department, Postgraduate Dental Education Center, Örebro, Sweden.


Professor Emeritus, Division of Orthodontics, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.


Senior Consultant and Associate Professor, Orthodontic Department, Postgraduate Dental Education Center; and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.