ectopic canines

Question 1

when should canines be palpated

Answer 1

Examine annually from age 8 (clinical inspection and bucal palpation of the alveolus)
Should be present at 9-10 years in buccal sulcus

Question 1

what are the risks of ectopic canines?

Answer 1

root resorption of adjacent teeth (incisors)
resorption of canine crown
cyst formation

Question 2

what is parallax?

Answer 2

radiographic technique used to locate the position of canine
refers to the apparent movement of an object based on the position of the beam
SLOB

Question 3

what is used for horizontal parallax?

Answer 3

2 periapicals

Question 4

what is vertical parallax?

Answer 4

OPT and periapical
or
OPT and upper standard occlusal

Question 5

what are the management options for ectopic canine?

Answer 5

interceptive extraction of deciduous canine
surgical exposure and ortho alignment
surgical removal of ectopic canine
transplantation
leave and monitor

Question 6

when should interceptive treatment be carried out?

Answer 6

age 10-13
better results in absence of crowding

Question 7

what is involved in interceptive treatment?

Answer 7

interceptive extraction of deciduous canine

when the ectopic canine isnt severely displaced

This can result in improvement in position of ectopic permanent canine although, warn patient they may need surgical exposure/ ortho alignment.

Question 8

what is the management if no improvement, 12 months after interceptive extraction?

Answer 8

alternative treatment options should be considered

Question 9

What is involved with surgical exposure and ortho alignment?

Answer 9

This is considered when interceptive treatment is not an option and when the patient is willing to wear fixed ortho (well motivated and good OH)

Question 10

When should surgical removal of an ectopic canine be considered?

Answer 10

If the patient declines active treatment
Or if there is evidence of early root resorption of the adjacent incisor teeth / no risk of damaging teeth during removal
Or when the ectopic canine is severely malpositioned

If there is good contact between lateral incisor and first premolar (if aesthetics are good) - can use ortho alignment here to help

Question 11

When would root canal therapy need to be carried out in transplantation cases?

Answer 11

If >3 quarters of the root has been formed
Carry out treatment within 10 days of transplantation

Question 12

When is no treatment an option?

Answer 12

If there is no evidence of root resorption of adjacent teeth/ any other pathology
If the patient is happy with the appearance

Question 13

When is transplantation a reasonable treatment option?

Answer 13

When the ectopic canine is grossly displaced or when prolonged ortho is unacceptable for the patient.

Question 14

What is a good indication for spontaneous eruption of the permanent canine after extraction of c?

Answer 14

If the ectopic canine is less than halfway across the lateral incisor

Question 15

What are the risks of doing nothing?

Answer 15

Cyst formation
More likely ro ankylosis over time
Resorption of the roots of adjacent teeth
Resorption of canine crown
Eventual loss of deciduous c

Question 16

What is an ‘open’ exposure?

Answer 16

Lift a flap
Make a window where the canine is (may have to remove bone)
Replace flap and completely suture it back, leave a pack where you have cut the window over the canine
Pack is left for 10 days (hopefully no healing of the mucosa over window)

Question 17

What is a ‘closed’ exposure?

Answer 17

Expose the canine
Put ortho traction hook on canine and attach a gold chain to pull down