unerupted ectopic canines

Question 1

Special investigations that can be done to assess the position of an unerupted maxillary canine

Answer 1

OPT and anterior maxillary occlusal
2x periapicals
- one centred on canine region
- one centred on upper central incisor
- parallax technique to localise canine
CBCT

Question 2

ectopic canine incidence

Answer 2

1 to 2% in Caucasian population

Question 3

risks of leaving an ectopic canine unerupted

Answer 3

resorption of roots of adjacent teeth
- 40% risk of lateral incisor root resorption
resorption of canine crown
- 14% risk
ankylosis of unerupted canine
eventual loss of primary canine and complex restorative solutions may be required in future
cystic change of canine (rare)

Question 4

Ectopic canine - treatment options

Answer 4

accept malcolussion
consider interceptive extraction of the C
surgical exposure and orthodontic alignment
surgical removal of ectopic canine
autotransplantation

Question 5

indications for autotransplantation of ectopic canine

Answer 5

malposition of tooth too great for orthodontic alignment to be possible
no evidence of ankylosis
canine root development is 2/3 to 3/4 length root
patient desires faster treatment option

Question 6

autotransplantation - risks

Answer 6

patient may need to undergo rct of transplanted tooth
patient needs to accept risk of ankylosis or root resorption