ORTHO ectopic canines Flashcards
what factors contribute to ectopic canines?
family history
females>males
class II div 2
hypodontia/ microdontia
late presentation
pathology - root resorption
what is interceptive treatment for ectopic canines?
extraction of Cs
what does the success of interceptive treatment for ectopic canines rely on?
the portion of the root of the lateral incisor overlap with the ectopic canine
- works best in uncrowded cases
if the interceptive treatment of ectopic canine doesnt work, what techniques can be used?
open exposure
closed exposure
surgical removal of canines
what is the risk of leaving ectopic canines?
cystic change (the tooth will therefore need to be removed)
canine appears later on in life
what guidelines do we follow regarding ectopic canines?
Royal College of Surgeons - management of the palatally ectopic maxillary canine
in ortho, when do you take xrays?
confirm unerupted teeth
locate unerupted teeth
pathology
root morphology
assess skeletal pattern
monitor tx changes
what type of radiographs do you take to locate ectopic canines?
vertical parallax - DPT + max occlusal
horizontal parallax - DPT + periapical
when do canines begin to develop?
4-5 months of age
when does crown calcification of the canines begin?
6-7 years
when do upper canines erupt?
11-12
when do lower canines erupt?
10-11
what percentage of the caucasian population experience impacted upper canines?
2-3%
when do we start examining for the canines? and how do we do this?
9 years old
palpate buccally and palatally
when chosing to not treat an ectopic canine, what must be performed routinely?
radiographs
describe in lay terms, open exposure for ectopic canines?
a small window of gum and bone is removed over the buried tooth to help it grow into the mouth
sometimes a gold chain or brace attachment is stuck on to the tooth either at the time of the operation or later on in the treatment
fixed braces are used to bring the canine tooth into the correct position
you may need to have other teeth removed to make enough space for the canine
what does an open exposure operation involve for the patient?
general or local anaesthetic
stiches after the operation and possible something to dress the canine
how long does open exposure of an ectopic canine take?
more than 2 years
does open exposure for ectopic canines always work?
usually, however in rare cases the tooth is fused to bone and will not move - if this happens, the tooth must be removed and the pt may require further dental tx
when may the option of complete removal of an ectopic canine be considered?
pt does not want to wear a fixed brace
the rest of the teeth are straight with no gaps
the buried tooth is in a poor position
the buried tooth is causing problems
why may 3s be buccally displaced?
as it is the last tooth to erupt anterior to the 6, if the upper arch is crowded
how are ectopic canines assessed?
palpation
inclination of the 2
radiographs: DPT + IO view or 2 IO views
when chosing to maintain a C, leaving the unerupted canine under radiographic view, what must the patient be warned of?
there must be no evidence of cystic change/ resorption
removal of 3 can be left until GA is required e.g., for extractions of 8s
patient must understand that C will eventually be lost, necessitating a prosthesis
state the circumstances in which exposure and ortho alignment is feasible?
- canine is in a favourable position
- sufficient space available for the 3, or can be created
- pt is willing to undergo surgery and prolonged ortho rx (2 years)
