Volume 5, Issue 2, February – 2020 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Clinical Innovation CANT Identification Device in

Orthodontics- Enabling Early Detection of
Occlusal CANT
Jayakrishnan1, Mithun K2, K Nillan Shetty3, Rohan Rai4, Anjali Jayaraj5
1,2,3,4
Department of Orthodontics and Dentofacial Orthopedics, A.J Institute of Dental Sciences, Mangalore, Karnataka, India
5
Department of Conservative Dentistry and Endodontics, Navodaya Dental College, Raichur, Karnataka, India

Abstract:- One among the most important aesthetic as having aesthetically pleasing faces6. The conclusion of
feature in smile aesthetics is the canting of occlusal their study was that the degree of asymmetry in facial
plane. Even though it is important, canting of occlusal structures increased with the distance from the cranium i.e.
plane is usually not evaluated during the routine clinical structures of the lower face were more asymmetrical
examination, mostly due to its camouflage effect by the compared to the upper face. Ferrario et al showed that
soft tissue structures. But this might create difficulty at variable degrees of soft tissue facial asymmetry in healthy
a later stage in treatment when its correction becomes Caucasian subjects7. All the studies anyways came to a
more difficult. Therefore, identifying occlusal cant at common conclusion that some degree of asymmetry was
the clinical examination phase becomes very critical. A often present in the craniofacial complex.
Cant Identifying Device (CID) for occlusal cant
detection is suggested in this article to equip the Even though most of the researches and data that are
clinician to identify occlusal cant chairside without available points to the fact that a degree of facial
missing out on this finding. It proves to be a handy tool asymmetry is present in all individuals, there is a difficulty
for the clinician and very effective when it comes to level in identifying this asymmetry. This is usually because
detection of occlusal cant. the soft tissues may compensate for the underlying skeletal
imbalances8. in addition, there are reports that the
Keywords:- CID, Occlusal CANT, Occlusal CANT individuals may mask facial asymmetry by their posture9.
Detection Device, Transverse Discrepancy. For example, tilting of the head may give the perception of
no occlusal cant in an individual with occlusal cant.
I. INTRODUCTION Therefore, it should always be a priority to assess the
craniofacial and dental asymmetry as a part of clinical
Smile aesthetics was always held high as a symbolic evaluation of the patients.
representation of beauty, but aesthetics was always a matter
of subjective perception. Smile analysis is also a key II. OBJECTIVES
element in Orthodontic treatment1, and smile designing has
become an integral part in the treatment planning The aim of the present study is to suggest an Occlusal
procedure. There are various studies that suggests different cant evaluation tool for easy identification of the dental
norms for the facial features for proper assessment of facial cant present in the patient. Severe occlusal canting can
characteristics2. Although definitive rules cant be put up to result in facial asymmetry and the extent of occlusal cant
define aesthetics, some guidelines can be formulated in determines the complexity of Orthodontic treatment.
order to optimize the Dentofacial aesthetics3.
Furthermore, any canting of the occlusal plane is
Among those characteristics, Occlusal Cant occupies a critical and needs to be identified as early as the diagnostic
higher niche in the dentofacial features. It describes the phase in Clinical examination in order to avoid any
vertical position of the teeth when the left and right sides potential complications during the treatment. Therefore, the
are at different occlusal levels. This can also be defined as prime objective of this article is to invent a device or tool to
the rotation of the occlusal plane upwards or downwards in enable the assessment of the occlusal cant in a patient
the transverse plan of one side over the other. Perception of clinically.
smile aesthetic varies among individual, races and ethnic
group. There are many studies reporting that all patients III. MATERIALS AND METHODS
seeking treatment will have some degree of craniofacial
asymmetry4. Shah and Joshi used measurements on The present invention utilises the Fox guide plane
Posteroanterior (PA) cephalograms to find the asymmetry mounted with spirit levels in order to evaluate the occlusal
in total facial structure and in the maxillary area5. cant. The bubble in the spirit level enables the clinicians to
assess the extent of canting of occlusal plane chairside. It
Similarly, Peck et al used PA cephalograms to analyse gives a more definitive insight of the cant both in the
the craniofacial asymmetry in a group of people thought of anteroposterior as well as the transverse dimensions.

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Volume 5, Issue 2, February – 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
This device is called as the Cant Identifying Device The patient is the examined from the frontal aspect
(CID) and is a simple tool which negates the use of any and also from the left (Fig 3) and right lateral (Fig 4)
commercially available complicated devices for cant aspects.
detection.

IV. DESCRIPTION OF INVENTION

The Cant Identifying Device (CID) consists of a fox

guide plane and a spirit level bubble leveller, which is
mounted on top of the CID (Fig 1).

Fig 3:- Right lateral aspects of the patient

Fig 1:- Cant Identification Device

The clinician places the guide plane inside the mouth

of the patient and instructs them to occlude normally (Fig
2).

Fig 4:- Left lateral aspects of the patient

The extent of occlusal canting can be identified

through this method. The bubble gives an indication as to
the side to which the cant is present. The lateral views give
an indication in variation of the left and right
anteroposterior occlusal plane in relation to the ala-tragus
line. This will enable the clinician to better evaluate the
patient and arrive at a proper diagnosis. It is very effective
Fig: 2- Patient occluding with the CID in patients whose soft tissues have compensated for the
occlusal cant and in whom canting of occlusal plane is not
so evident.

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Volume 5, Issue 2, February – 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
The advantages of this device are: change in occlusal cant. Recording of the Occlusal cant at
1. Clinician can easily visualize the cant of occlusal plane the initial stages are very important as the development of
from the frontal and lateral views occlusal cant at a later stage in treatment usually points to a
2. Easily available faulty treatment biomechanics. Therefore, this device also
3. Less bulky helps to assess the changes in the occlusal canting and also
4. Comfortable to the patient helps to evaluate the success of treatment measures aimed
5. Economical at correcting occlusal cant.
6. Easily recordable using the frontal and Profile
Photographs VI. CONCLUSION

The main disadvantage with this device is that the Although occlusal cant should be identified before the
amount of occlusal cant cannot be quantified to any beginning of Orthodontic treatment, it is often overlooked
measurement or the degree of canting of occlusal plane due to the soft tissue compensation in most of the patients.
cannot be measured. Clinicians usually are hurried onto correction of other
malocclusions, when the occlusal cant goes unnoticed
V. DISCUSSION initially. But the severity of treatment usually rests on the
degree of occlusal cant and its correction is to be initiated
An occlusal cant is one of the characteristics that must in order to avoid detrimental effects on mastication. Even
be evaluated during clinical examination in all patients though esthetics is a subjective perception, the device
seeking Orthodontic treatment as it determines the severity presented in the article would enable the clinician to better
of the treatment. Most of the commercially available judge the patient’s occlusal cant easily during the clinical
devices relate the jaw to a reference point or plane examination.
regardless of the orientation of the occlusal plane. The
neglect of the occlusal plane orientation usually renders REFERENCES
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