Ortho - Lecture 14: Impacted Teeth Flashcards
Tooth that has failed to erupt partially or completely to its correct position in the dental arch and its eruption potential has been lost
Impacted tooth
Most common impacted tooth
Maxillary canine
Impacted maxillary canines are twice as common in ___________
females
The most common cause for impacted maxillary canines is inadequate _______ _________
arch length
Eruption in an abnormal position (ex: transposition)
Ectopia
Palatally impacted canines occur _______ of the time
2/3
Labially impacted canines occur ______ of the time
1/3
Palatally impacted canine or labially impacted canine?
Due to genetics
Palatally
Palatally impacted canine or labially impacted canine?
Due to arch length discrepancy
Labially
Palatally impacted canine or labially impacted canine?
85% had sufficient space
Palatally
Palatally impacted canine or labially impacted canine?
17% had sufficient space
Labially
What are the following causes of?
Genetics
Retained deciduous
Not enough space
Short lateral roots
Abnormal eruption sequence
Trauma to primary tooth bud
Premature root closure
Eruption into cleft
Canine impaction
Palatally impacted canine or labially impacted canine?
Usually vertical
Labially
Palatally impacted canine or labially impacted canine?
Usually horizontal
Palatally
What age?
First evidence of permanent canine calcification
4-5 months
What age?
Crown formation of permanent canine
5-6 years
What age?
Eruption of permanent canine
11-12 years
What age?
Completion of root of permanent canine
13-15 years
What are the clinical signs of an impacted canine?
Delayed eruption
Prolonged retention of primary
Elevation of soft tissue
Distal migration of laterals
Palatally impacted canine or labially impacted canine?
On a ceph, appears vertical and
coronal to the apices of the anterior teeth
Labially
Palatally impacted canine or labially impacted canine?
On a ceph, appears horizontal and apical to the anterior teeth
Palatally
Palatally impacted canine or labially impacted canine?
On a pano, appears larger and more blurry than the contralateral canine
Palatally
Palatally impacted canine or labially impacted canine?
Detected earlier
Labially
Palatally impacted canine or labially impacted canine?
Easier to manage
Labially
Palatally impacted canine or labially impacted canine?
May be transposed
Labially
Palatally impacted canine or labially impacted canine?
Watch for 6 month difference from contralateral canine
Palatally
Palatally impacted canine or labially impacted canine?
Treat early!
Palatally
What are the tx options for impacted canines?
Exposure + natural eruption
Exposure + ortho
Ext + premolar substitution
Reimplantation
Palatally impacted canine or labially impacted canine?
Usually need just simple uprighting and extrusive mechanics; anchorage preservation is chief concern
Labially
Palatally impacted canine or labially impacted canine?
During surgery, the flap design should preserve attached gingiva
Labially
Palatally impacted canine or labially impacted canine?
Closed eruption of apically repositioned flaps
Labially
Palatally impacted canine or labially impacted canine?
Must have adequate exposure for bonding
Labially
Palatally impacted canine or labially impacted canine?
Stabilize arch and make space
Palatally
Palatally impacted canine or labially impacted canine?
Full thickness flap is done (open or closed eruption)
Palatally
Palatally impacted canine or labially impacted canine?
Consider good hemostasis; bone removal if necessary
Palatally
Why should you ext the primary canine if it is retained?
To facilitate eruption
