Decision-Making Criteria of Odontectomy or Surgical Exposure in Impacted Maxillary Canine Based on Treatment Difficulty Index Modification.

David Buntoro Kamadjaja,Coen Pramono Danudiningrat,Ganendra Anugraha,Liska Barus,Andra Rizqiawan,Reza Al Fessi,Olivia Jennifer Gunardi,Indra Mulyawan,Shigehiro Ono,Muhammad Subhan Amir,Ni Putu Mira Sumarta

doi:10.1055/s-0041-1739447

David Buntoro Kamadjaja, Coen Pramono Danudiningrat + Show 9 more

Open Access

https://doi.org/10.1055/s-0041-1739447

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Abstract

Canine impaction is a difficult condition to treat, and it usually necessitates a combination of surgical exposure and orthodontic traction or surgical extraction. An accurate assessment of the maxillary canine's position can help determine the severity of the impaction, the difficulty of therapy, and the treatment's prognosis. A total of 55 impacted canines were studied and selected retrospectively. Difficulty indexes were used to measure the severity of impaction with pretreatment panoramic radiographs. Pearson correlation was used to test the validity of the difficulty index modification score. Regression statistical analysis was used to evaluate any correlation between total scoring from each index with surgical treatment. The validity test on the variable modification index score showed a valid value (p = 0.000). According to both treatment difficulty and modification index, odontectomy group showed higher mean of total scoring than surgical exposure group. Treatment difficulty and modification index showed a significant correlation with surgical treatment (p = 0.003 and p = 0.001). The higher the severity of canine impaction, the greater is the possibility of odontectomy than surgical exposure. Both indexes can consider to be used in determining surgical treatment planning.

Highlights

The management of maxillary canines’ impaction is very important to know, considering these teeth are the second most common teeth that have a tendency to impact after third molars, with a prevalence in the range of 1.1 to 13% of the population.[1,2,3] Surgery on these teeth is one of the most common surgical procedures in treatment planning, due to aesthetic and functional reasons
The higher the severity of canine impaction, the greater is the possibility of odontectomy than surgical exposure
Both indexes can consider to be used in determining surgical treatment planning

Summary

Introduction

The management of maxillary canines’ impaction is very important to know, considering these teeth are the second most common teeth that have a tendency to impact after third molars, with a prevalence in the range of 1.1 to 13% of the population.[1,2,3] Surgery on these teeth is one of the most common surgical procedures in treatment planning, due to aesthetic and functional reasons. Decision-Making Criteria in Impacted Maxillary Canine Gunardi et al. Decision-Making Criteria in Impacted Maxillary Canine Gunardi et al These canines, it is very important to be able to preserve the canines that are not fully erupted or predicted to be impacted, such as with surgical exposure and orthodontic traction.[4,5]. Forced eruption of an impacted canines usually requires surgical and orthodontic intervention to allow the canines to reach the proper position in the dental arch without major damage to the other teeth.[6] But this method is not always possible. If the impacted canine cannot be preserved due to its location, an odontectomy may be considered.[7,8,9] Panoramic radiograph is the main routine investigation in cases of canine impaction, and is often combined with other radiological techniques to help diagnose and determine more accurate location of impacted canine.[10,11] Canine impaction require a very complex, multidisciplinary therapeutic management, considering its long treatment time, high cost, and many other factors that can affect the final treatment outcome.[6,12]

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