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Orthodontics > Ectopic Canines > Flashcards

Ectopic Canines Flashcards

0
Q

What are the problems with canines?

A

Ectopic

Transposed

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1
Q

Why are canines important?

A
  • Corner stones of dental arch
  • Long rooted teeth so good long term prognosis for perio
  • Difficult replace prosthetically
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2
Q

What percentage of maxillary canines are ectopic?

A

2-3%

85% Palatal
15% buccal

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3
Q

What percentage of ectopic canines are associated with root resorption of the laterals?

A

12% more common with Palatal

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4
Q

How does the canine migrate during eruption?

A

It migrates down and forward distal to the root of the lateral incisor

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5
Q

At what age shoud canines be palpable in the buccal sulcus?

A

9/10

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6
Q

What age do canines erupt?

A

12

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7
Q

What are the causes for ectopic canines?

A
  • Retained C
  • Displacement of dental crypt
  • missing laterals/diminutive lateral
  • Crowding (especially buccally)
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8
Q

Why are missing or diminutive laterals associated with ectopic canines?

A

Less guidance

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9
Q

What do you need to examine when investigating canines?

A

Presence
Position
Pathology

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10
Q

What are the clinical signs of possibly ectopic canines?

Reference

A

brin et al 1986

  • Not palpable in buccal sulcus by aged 10
  • C’s not mobile
  • Asymmetric loss of C’s
  • peg shaped laterals
  • Missing laterals
  • labially inclined laterals which suggests buccal,impactin
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11
Q

What can you use as an adjunct to clinical examination to determine presence and location of 3’s?

A

Radiograph

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12
Q

What must you look for on the radiographically examination?

A
  1. C’s root resorbing?
  2. Any signs of pathology eg resorbing roots of laterals or centrals
  3. Determine position
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13
Q

What radiographically technique is used to determine the position of the 3’s?

A

Parallax

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14
Q

What is the principle to parallax?

A

Relative movement of the canine in relation to other adjacent teeth when two radiographs are taken with an angle between them

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15
Q

what rule do we use to determine the position of the tooth when using parallax?

A

SLOB
Same Lingual
Opposite Bucaal

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16
Q

What radiographic views can you use in horizontal parallax?

A

Ant occlusal and Periapical
2 pas
DPT and pa

17
Q

What views can you use in vertical parallax?

A

DPT and ant occlusal

18
Q

What interceptive techniques are there for impacted canines ? Ref

A

Ericsson and kurol 1988
1. Extraction of C’s
At age 10-13
Suggested 78% will improve of there is no crowding (power and short 1993)

19
Q

When is interception indicated and more successful?

A
  1. Young patent ~10
  2. Space available
  3. 3 only overlaps lateral but not central
20
Q

When is active treatment indicated ?

A
  1. Pt aged 13
  2. Crowded case
  3. If canine does not improve significantly 6 mths post extraction
21
Q

What are the treatment options following ectopic canines?

A
  1. leave alone and review
  2. Expose and align
    3.extarct plus or minus ortho
    4 create space and replace
    5.transplant
22
Q

What are the factors to consider when deciding which treatment?

A
  • Position of canine
  • Crowding
  • Age of pt
  • Cooperation
  • Condition of root of C
  • Appearnce of lateral
  • Other pathology
23
Q

What circumstances would you leave the ectopic canine and review?

A

Canine in hopeless position
Pt not interested in treatment
Increased risks from surgery to pt
C has good root morph

MUST make sure review radiographically

24
Q

What three things do you need to consider when assessing the position of the canine for ortho?

A
  1. Height
  2. mesio-distal position
  3. Angulation
25
Q

Discuss the issues of canine height with regards to ortho prognosis ?

A

The crown tip of the canine is at or above the apical third of the incisor roots: POOR PROG

26
Q

Discuss the issues of canine mesio distal position with regards to ortho prognosis ?

A

Canine is more than half way across the upper incisor : POOR PROG

27
Q

Discuss the issues of canine angulation with regards to ortho prognosis ?

A

Smaller than angle with the occlusal place (the more horizontal) POOR PROGNOSIS

28
Q

When is expose and alignment a good option?

A

Age: longer treatment period in older patient s
Co-operation: 2+yrs of treatment
OH
MH: since surgical treatment

29
Q

T/F

Expose and Alignment is usually a treatment option of choice ?

A

T

In well motivated patients and canine in an okay position and enough space or can make space

30
Q

What is important when there is buccal inaction?

A

Avoid pulling through non keratinised mucosa so need to

  1. bond bracket and gold chain or
  2. use an apically repositioned flap
31
Q

How do you perform the expose and aligning?

A

Expose crown and leave to erupt for 8 weeks then apply traction

Buccal - closed exposure
Palatal - open exposure

32
Q

When would you chose to extract plus or minus ortho?

A

In v crowded cases where 4/2 makes good contact
Poor prognosis for alignment and risk of lateral resorption
Patient not interested in ortho but leaving canine is a risk

33
Q

What are the restorative treatment options?

A

Bridge: not ideal due to canine guidance on Pontic
Implant: not in growing patient

34
Q

When would transplants be indicated?

A

Rarely
Poor long term prognosis and operator sensitive
Better prognosis if root is only 2/3 formed

Need ortho anyway to create space
Possibility of tooth ankylosis in growing pt

35
Q

Which tooth are maxillary canines most commonly transposed with?

A

First premolar

Sometimes lateral

36
Q

Which tooth are mandibular canines most commonly transposed with?

A

Lateral

37
Q

What do you do in cases where the canine is transposed ?

A

Do not try to move the canine back
Accept and align with FA
Rotate 4 medically to hide Palatal root

38
Q

What percentage of mandib canines are ectopic?

A

0.3%

39
Q

Which gender have ectopic Maxilliary canines more?

A

Females

40
Q

What are palatally impacted canines mainly caused by?

A

Polygenic

Multifacotrial

41
Q

What is buccal canine impaction mainly causes by?

A

Crowding

Orthodontics (28 decks)

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