Impacted canines Flashcards
how commonly impacted
second most commonly impacted tooth
cause of canine impaction
lack of space
aetiology of canine impaction
non-resorption of deciduous teeth, ankylosis of impacted canine, contraction or collapsed maxillary arch, absence of lateral incisor to guide eruption
clinical investigations
palpate, evidence of rotation/ tilting of adjacent teeth, mobility, 6 months since contralateral tooth erupted, presence of deciduous canine
radiographs for impacted canines
parallax films - PAx2, occlusal and DPT
CBCT
treatment options for impacted canines
conservative, interceptive, exposure, surgical removal, transplantation
Conservative tx
patient unwilling to have orthodontist or happy with appearance, good contact between 2 and 4 or healthy c, adjacent teeth vital
radiographs shows tooth very high, no associated pathology or resorption - usual after 14 years of age
interceptive tx
extract the deciduous canine
exposure and alignment
well motivated pt willing to have orthodontist tx and good oral hygiene
open technique
apically repositioned flap or palatal window
surgical removal - tx
patient non-compliant or satisfactory appearance with C or 2-4 contact, advanced resorption of incisors or malpositioned canine with difficult morphology
closed technique
orthodontic bracket and gold chain
technique for surgical removal
commonly palatal flap as per exposure
remove overlying bone to maximum convexity of tooth and elevate
sectioning may be required
may need buccal approach to section
plate may be required post operatively
when do transplantation
poor patient compliance or limited time desirable, poorly positioned canine without ankylosis, open apex desirable, may simply rotate around axis, need adequate space and bone
technique for transplantation
access as for removal but atraumatic elevation, socket ‘friction-fit’, minimal time > 10 mins, may require splint imobilisation, check is free of occlusion, post op check vitality and resorption
