Ectopic canines

Question 1

Aetiology/possible causative factors

Answer 1

Long path of eruption, genetic link (assoc with other anomalies e.g. class2dv2, missing/diminutive upper laterals, more common in females), crowding (often last tooth to erupt), ectopic position of tooth germ

Question 2

In what situations might the ectopic canine be surgically removed?

Answer 2

Canine not deemed alignable, no significant risk of damage to adjacent teeth during surgical procedure, pt happy with appearance and retained c has good long term prognosis, radiographic evidence of early root resorption of adjacent teeth, pt doesn’t want to wear ortho appliance

Question 3

Explain surgical exposure of ectopic canine and orthodontic alignment treatment option

Answer 3

Make sufficient space for tooth (may involve removing retained c), surgical exposure and orthodontic traction (closed exposure with gold chain for buccal canine, open exposure with traction hook for palatal canine), upper and lower fixed appliances (highly anchorage demanding - need palatal arch), retainers

Question 4

When might autotransplantation be indicated?

Answer 4

Malposition of canine too great for orthodontic realignment, no evidence of ankylosis of canine, canine root development ideally 2/3 to 3/4 root length, pt looking for quicker treatment option

Question 5

What risks of autotransplantation does the patient need to be warned about

Answer 5

Transplanted tooth may need to undergo root canal treatment, ankylosis or external root resorption of transplanted tooth