Unerupted Maxillary Canines

Question 1

What age would you be concerned maxillary canine not erupted?

Answer 1

Suspect ectopic if not palpable between age 10-11 years
Between 11-12 years
Maxillary canine erupt 12 in girls/ 13 in boys is considered late

Question 2

What characteristics make think a canine is bucally placed?

Answer 2

Buccal canine bulge
Mesially included upper incision

Question 3

When take RADs for unerupted canine?

Answer 3

Pronounced different in eruption of LHS/ RHS
Canines can’t be palpates and occlusal development is advanced
Lateral incisors shows pronounced proclination or buccal displacement

Question 4

What should look for on RAD?

Answer 4

crown and apex of tooth relative to adjacent teeth
prognosis deciduous retained canine
resorption/ pathology adjacent teeth
hypodontia
presence of obstructions

OPT is good for this

Question 5

What is technique used to locate ectopic canine?

Answer 5

Parallax
Two radiographs - OPT/ USO or two PAs at different view

Question 6

What rule to use when using parallax?

Answer 6

SLOB rule
See which way the canine has moved in repeated to tube

Question 7

When would CBCT be indications?

Answer 7

Unclear if root resorption
To aid surgical planning close to important anatomical structures

Question 8

What are 4 factors that affect tx planning ectopic canines?

Answer 8

pt motivation
malocclusion
severity of displacement and prognosis
condition and appearance retained canine
prognosis of adjacent teeth

Question 9

What are the clinical and radiographic indications for referral?

Answer 9

Canine not palpable at 10 years
Primary canine not showing root resoprtion
Rads indicating ectopic position
Canine crown overlap distal incised root
Enlargement of canine follicle

Question 10

What are tx options for ectopic canine?

Answer 10

No tx
Interceptive extraction C
Surgical XLA of impacted canine
Ortho alignment following surgical exposure and extraction retained c
autotransplantation

Question 11

When to interceptive XLA of c?

Answer 11

if ectopic canine not severely displaced, xla of c can result in improvement in position of canine

Question 12

When could surgical XLA of impacted tooth only be considered?

Answer 12

Primary canine is of acceptable appearance/ prognosis and pt doesn’t want ortho or if upper arch severely crowded

Question 13

What is autotransplantation?

Answer 13

Surgical removal impacted canine and placement into correct position in the arch