palatally ectopic maxillary canines Flashcards
What is the prevalence of maxillary canine impaction?
1.5%
Describe the aetiology of palatally ectopic canines?
Family history
Dental anomalies - missing, or malformed lateral incisors
When should canines be palpable in the buccal sulcus?
10-11
When are erupting maxillary canines considered to be late?
12 in girls
13 in boys
What are the sequelae of ectopic canines?
Root resorption of adjacent teeth - usually the incisors
Higher incidence where previous impaction of upper FPM
Resorption of the canine crown
Cystic changes
What are the different treatment options for palatally ectopic maxillary incisors?
Interceptive treatment by extraction of the primary canine
Surgical exposure and orthodontic alignment
Surgical removal of the palatally ectopic permanent canine
When is extraction of the primary canine done and how is tx carried out?
When ectopic canine is not severely displaced
Pt 10-13
Absence of crowding
May need to maintain space
If radiographic examination reveals no improvement in the canines position 12 months after XLA of primary, consider alt tx option
When is surgical exposure and orthodontic alignment carried out?
If XLA of primary canine not suitable
Pt willing to wear fixed ortho appliances
Well motivated and good OH and dental health
Degree of malposition not impractical (close to midline, above apices of adjacent teeth, horizontal angulation)
Likelihood of success decreases with age
When is surgical removal of the palatally ectopic canine carried out?
If patient declines active tx or is happy with their dental appearance
Radiographic evidence of early root resorption of incisors (if severe then exposure and alignment recommended)
If good contact between lateral and premolar
If pt willing to undergo ortho for substitution of the first premolar for the canine
Discuss risks of damage to neurovascular supply of adjacent teeth