ectopic maxillary canine Flashcards
(17 cards)
What does the normal maxillary canine look like?
Starts developing 4-5 months
Longest path of eruption
Palpable at 9-10 yrs
Erupts 11-12 yrs
Width 7-9mm
What is the prevalence of displaced maxillary canines?
1-3%
85% palatal, 15% buccal
8% bilateral
Associated w missing/peg laterals
What is the aetiology of ectopic canines?
Familial/genetic
Long path of eruption
Guidance theory- guided by roots of laterals? So if missing/peg- no clear route
Crowding- chronology of eruption, canine comes later
Lack of resorption of C
Follicular disturbance
What are traits/links with ectopic canines?
More female
Hypodontia
Peg shaped laterals
Transposition
Ectopic position of other teeth
Impacted 6
Intra occlusion deciduous teeth
Delayed eruption of permanent
What is infra occlusion?
Teeth are found w their occlusal surface below adjacent teeth long after they should have reached occlusion
How do you locate a canine clinically?
Palpate around sulcus
Mobility of C
Space for tooth
Angulation of lateral
How do you locate a canine radiographically?
Parallax
-OPT (8 degrees)
-upper standard occlusal (65 degrees)
SLOB (same lingual, opposite buccal)
CBCT- exact location, 3D, higher dose
What are complications of ectopic canines?
Root resorption
Ankylosis
Cysts (rare)
Eruption under bridge/denture
How do you manage an ectopic canine?
Leave alone
Intervention/interceptive
Extract
Ortho alignment
Transplant
What is intervention/interceptive tx for ectopic canines?
Extract C before 11 years old
91% improvement if crown distal to lateral midline
64% if mesial to lateral midline
Not strong conclusions
How can you assess the prognosis of the ectopic canine?
- Overlap of incisor
- Vertical height (how far up compared to roots)
- Angulation
- Position of apex (above which tooth)
How can you aline the canine?
Open exposure- surgery to expose, pack with special gauze to prevent gum healing over and then attach and traction (apically repositioned flap)
Closed exposure- surgery to access tooth, bond gold chain, gum stitched back
Create space- encourage natural eruption
No difference between open/closed
How do you manage a palatal impaction?
- Leave in situ, monitor
- Extract
- Expose and align
- Transplant
What are indications for transplantation?
If canine is ankylosed
Pt not suitable for ortho
Poor prognosis of C
Adequate space
No over eruption of opposing tooth
Too misaligned for ortho
What are problems w transplantation?
Nerve doesn’t like tooth to be dragged
So will cause radiolucencies
Tooth needs to be root treated
Can still cause generalised resorption
What is the prognosis of transplantation?
5 years- 72% good
10 years- 54% good
Depends on many things
What is your role as a GDP with ectopic canines?
- Diagnose early
- Palpate at age 9-10
- Look for other clinical indicators for normal/non eruption
- Get advice/refer
