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Ectopic / Impacted maxillary canines |
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The ectopic eruption and impaction of the permanent maxillary canine is a frequently encountered problem, second only to the mandibular third molar in its frequency of impaction
1.7 % prevalence Palatal impaction occurs in 85% of cases
Complications Include:
¨ Poor aesthetics ¨ Root resorption can be expected in 12.5% of incisors adjacent to ectopic canines ¨ Internal/external resorption of canine ¨ Infection associated with partial eruption ¨ Migration of adjacent teeth
Diagnosis:
Based on clinical (visual inspection and digital palpation) and radiographic examination. The possibility of canine ectopia should be considered if the maxillary canine is not palpable in the buccal sulcus by the age of 10-11 years, or if palpation indicates an asymmetrical eruption pattern
Treatment Options
¨ Leave in situ and accept aesthetics ¨ Surgical removal of ectopic tooth ¨ Exposure and bonding of tooth to bring it into alignment
Radiographic Examination
Radiographic examination involves two radiographs and application of the parallax principleHorizontal ParallaxAnterior occlusal and periapical or two periapicalsVertical ParallaxAnterior occlusal and DPT or periapical and DPTPlanning Surgical exposure and orthodontic alignmentFactors to be taken into consideration as outlined by the National Clinical Guidelines 1997:¨ The patient should be willing to wear fixed orthodontic appliances¨ The patient should be well motivated and have good dental health¨ The degree of malposition should not be too great to preclude orthodontic alignment
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