Orthodontic management of impacted maxillary canines

Abstract

The prevalence of impacted maxillary canines is 2–3%. In Caucasian populations, it is reported to be more palatally displaced than buccally, with the opposite trend seen in Asian populations. At the ages of 9–11 years, the position of the canine germ should be diagnosed, for most children through clinical supervision. In 7–10% of children, the clinical investigation must be supplemented with radiographic investigation, in most cases with intraoral radiographs. About 50% of impacted canines cause root resorption of the adjacent teeth. To detect the severity of resorption, cone-beam computed tomography is necessary. Root resorptions on incisor roots occur most often at 11–12 years of age. Early diagnosis of ectopically positioned maxillary canines is very important. In cases with palatally displaced canines and no root resorptions, extraction of the primary canines has been found in different studies to give good results. If the permanent canine has not started to normalize its position within 12 months, orthodontic treatment must be taken in consideration. Often, this is done by surgical exposure and orthodontic traction of the canine out into the dental arch.