impacted canines Flashcards
(26 cards)
what are the second most commonly impacted tooth after 3rd molars
canines
canines are more commonly ectopic bucally or palatally?
palatally
canines are palpable in the labial sulcus at what age?
10-11yrs
what tooth is important for the eruption of canines?
lateral incisors for guidance plane
what are the consequences of not treating an impacted canine? 3
Resorption of incisor roots
cystic change
Infection of cyst when close to surface mucosa, possible sinus formation
management of impacted canine when resorption of the lateral has occured 2
Extract incisor and put canine in space
Extract canine and incisor and leave space for prosthodontic appliance
signs of an impacted canine
can’t palpate it
rotating/tilting of adjacent teeth
mobility/sensibility of adjacent teeth
6 months since contra-lateral canine erupted
presence of deciduous canine beyond normal age of shed
what are the 5 management options for impacted canines?
conservative
interceptive
exposure and alignment
surgical removal
transplantation
when would a conservative approach to managing an impacted canine be applicable 5
Pt doesn’t want ortho
Happy with appearance with good contact between the 2 and 4
Healthy C and adjacent teeth are vital
Tooth very high
No associated pathology or resorption
what is the interceptive approach to manage an impacted canine?
extract deciduous canine - C
when would an interceptive approach to managing an impacted canine be applicable?
If pt 10-13yrs, minimal crowding and space maintenance
when would an alternative management be required after an interceptive approach?
If no change in position radiographically after 12 months need alternative treatment
when would exposure and alignment to manage an impacted canine be applicable?
Motivated pt, wants ortho and good OH
not grossly displaced
favourable root morphology
when exposing and aligning an impacted canine which is better, open or closed technique? why?
closed technique as better aesthetics at gingival margin
what flap design is used for exposing and aligning impacted canines?
3 sided flap or window
indications for surgical removal of impacted canines
non-compliant pt happy with the c/2-4 contact
advanced resorption of incisors
difficult canine root morphology
what flap design is used for surgical removal of impacted canines?
envelope flap
how far does the flap extend if its a unilateral impacted canine?
1-4
how far does the flap extend if its a bilateral impacted canine?
4-4
May need to sever incisive foramen - not a problem as greater palatine nerves grow forward to innervate the area
when surgically removing impacted canines follicular tissue attached to the ACJ needs to be removed why?
can undergo cystic change
what is autotransplantation?
take pt own teeth and place in a different position
indications for transplantation
Poor pt compliance or limited treatment time
Poorly positioned canine without ankylosis
adequate space and bone
what is desirable for a tooth being transplanted?
Open apex desirable - chance of reestablishment of blood supply
during transplantation why do u need to Atraumatically elevate the tooth?
to avoid the PDL so it can re-establish
