Ectopic Canines Research Articles

Frequency and association of maxillary ectopic canine with incisor root resorption and dental agenesis.

To assess the frequency of maxillary ectopic canine both buccally and palatally displaced with incisor root resorption and dental agenesis. The cross-sectional study was conducted from April 8 to June 29, 2019, at the Department of Orthodontics, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, and Dow Dental College, Dow University Of Health Sciences, Karachi, and comprised orthodontic patients diagnosed with maxillary ectopic canine eruption. Root resorption and agenesis were diagnosed on panoramic films. Root resorption was further confirmed by periapical radiographs. Data was analysed using SPSS 21. Of the 98 subjects, 86(87.8%) had buccally displaced canines of which 38(44.2%) were associated with root resorption, while 12(12.2%) patients had palatally displaced canines of which 10(83.3%) had root resorption (p=0.011). Overall, 30(30.6%) lateral incisors were resorbed, 7(7.1%) both central and lateral incisors, 5(5.1%) premolars, and 6(6.1%) both lateral incisors and premolars were resorbed. Agenesis was detected in 10 (10.2%) subjects (p=0.62). There was found to be no association of maxillary ectopic canines with incisor root resorption and dental agenesis.

Photobiomodulation Therapy on Orthodontic Movement: Analysis of Preliminary Studies with a New Protocol.

This study aimed to investigate the effectiveness of photobiomodulation therapy (PBMT) on the acceleration of orthodontic movements, deriving from its biostimulating and regenerative capacity on soft tissues, consequent to the increase in differentiation, proliferation, and activity of cells that are involved with alveolar bone remodeling. The present randomized controlled trial was conducted on six patients who required extractive orthodontic therapy because their ectopic canines had erupted. A total of eight canines were analyzed, four of which received laser irradiation (i.e., experimental group). Two weeks after the extractions, all canines of the experimental and placebo groups were distalized simultaneously and symmetrically with the laceback retraction technique. The PBMT protocol consisted of four cycles of laser applications, one each on days 0, 3, 7, and 14 of the study, with session treatment durations of 2–4 min. The results of the descriptive analysis on the distal displacement speed of the canines after 1 month of follow-up indicate an average displacement of 1.35 mm for the non-irradiated group and 1.98 mm for the irradiated group. Through inferential analysis, a statistically significant difference (p < 0.05) was found between the average speed of the irradiated canines and the control canines. The low energy density laser used in this study, with the parameters set, was found to be a tool capable of statistically significantly accelerating the distal displacement of canines.

Impacted canines – interceptive treatment

Canines, especially upper canines, are the second most frequently impacted permanent teeth, after third molars. Orthodontic extrusion of ectopic impacted canines is often complex, long-lasting and may lead to iatrogenic complications. In children, implementation of interceptive treatment helps to normalise the canine position in the alveolar process and its spontaneous eruption. &lt;b&gt;Aim.&lt;/b&gt; The aim of the study was to review the literature regarding the methods of interceptive treatment for impacted maxillary and mandibular canines supported by relevant clinical examples. &lt;b&gt;Material and methods.&lt;/b&gt; A review of literature on interceptive treatment of impacted canines has been performed for the period 1961–2018. The medical databases PubMed and Medline were used. &lt;b&gt;Results.&lt;/b&gt; Extraction of deciduous maxillary canines and maxillary first deciduous molars, maxillary expansion with rapid maxillary expanders and transpalatal arches, also in combination with extraoral traction and space opening the dental arch with fixed appliances are effective methods of interceptive treatment in patients at the developmental age with impacted upper canines. There is no effective protocol for interceptive treatment for impacted mandibular canines described in the literature. &lt;b&gt;Conclusions.&lt;/b&gt; The use of interceptive treatment in growing patients positively influences spontaneous eruption of ectopic impacted maxillary canines. Early clinical and radiological diagnosis of ectopic canine position is very important for success. &lt;b&gt;(Abramczyk J, Zadurska M, Czochrowska E. Impacted canines – interceptive treatment. Orthod Forum 2018; 14: 224-36).&lt;/b&gt;

Maxillary Canine Ectopia and Maxillary Canine-Premolar Transposition are Associated with Deviations in the Maxilla

The purpose was to analyze the direction of the infraorbital canal and the palatal width in cases with maxillary ectopic canines, all oriented horizontally and erupted labially, and with canine transposition and to compare findings with normal values. Eight anthropological human skulls, four with these horizontally oriented ectopic canines and four with canine-premolar transposition comprised the study. A radiopaque marker was placed in the infraorbital canal and frontal and profile radiographs were taken of each skull. Cephalometric measurements evaluated the canal direction (IOt angle). Interorbital (IO) and palatal widths (PW) were measured directly on the skulls. A general linear model was used for statistical analysis. Maxillary canine ectopia: IOt ( x = 8.54; 95% CI of -3.95 and 21.04; P = 0.18) was larger, PW ( x = 3.37; 95% CI of 0.51 and 6.23; P = 0.022) was significantly smaller and IO ( x = 1.49; 95% CI of -2.62 and 5.61; P = 0.47) was also smaller. Maxillary canine-premolar transposition: IOt ( x = 17.27; 95% CI of 4.78 and 29.76; P = 0.008) and PW ( x = 3.34; 95% CI of 0.48 and 6.21; P = 0.023) were significantly smaller and IO ( x = 2.94; 95% CI of -1.17 and 7.06; P = 0.16) was smaller, but not significantly. Eruptional deviations in the maxillary canines-premolars are associated with maxillary deviations expressed as the direction of the infraorbital canal and the transpalatal width. Accordingly, dental and osseous deviations within the maxillary developmental field are interrelated.

Audit on locating ectopic canines

Audit on locating ectopic canines

Which One of Two Ectopic Mandibular Canines will erupt to a Normal Position in the Dental Arch

The purpose of this paper is to demonstrate 4 cases with bi-lateral ectopic mandibular canines and to demonstrate in each case which one of the two canines erupted to a normal position in the dental arch. The canines are observed from Orthopantomograms from 4 children (aged 8-13 years of age) in the mixed dentitions stages. Of these children 2 were males and 2 were females. From each child there was between 3-5 Orthopantomograms. These were observed over 3-4 years period. In each of the 4 cases with bi-lateral ectopia of the mandibular canines the one mandibular canine erupted into a normal position, while the other one declined into a horizontal position during the mixed dentition period. These 4 cases demonstrated that the inclination of the canines were important to observe and diagnose from the initial stage (first ortopantomogram). The cases presented, demonstrated that the unsuccessfully erupted canines ending in a horizontal position, were the canines which inclined slightly more that the contra lateral canine already from the initial stage.

Novel Technique of Auto Transplantation of Ectopic Canines in Growing Patients

Novel Technique of Auto Transplantation of Ectopic Canines in Growing Patients

Association between Ectopic Mandibular and Maxillary Canines

The aims of the present study were (1) to assess the prevalence of ectopic mandibular canines and (2) to evaluate whether an association exists between maxillary and mandibular canine ectopia. The records of 983 patients (males and females) were divided systematically into two groups: group I (454 patients) (control group) included patients who attended the clinic from September 2013 to August 2014, while group II (529 patients) included patients who attended the clinic from September 2014 to August 2015. Group I was used to assess the prevalence of ectopic mandibular canines in the population, while group II was used to obtain 40 radiographs of ectopic maxillary canines, which comprised group To investigate any association between maxillary and mandibular canines, the prevalence of ectopic mandibular canines was assessed in group Canine positions were assessed as follows: (1) amount of horizontal canine overlap with the adjacent lateral incisor root; (2) the angle between the canine and true vertical. The prevalence of ectopic mandibular canines in the population (group I) was 5.3% (24 of 454 patients); in group 22.5% (9 of 40) of maxillary canine cases exhibited ectopic mandibular canines. Group II1 had a significantly higher prevalence of ectopic mandibular canines than did the control group (group I) (p < 0.001). The prevalence of mandibular ectopic canines was 5.3%. Ectopic mandibular canines were highly associated with ectopic maxillary canines; a quarter of patients with ectopic maxillary canines are expected to have mandibular ectopia. Dentists should be aware of all dental anomalies, particularly, impacted canines. Early and interceptive management of impacted canines increases the chance of canine eruption.

Interest in the early extraction of temporary maxillary canines to prevent the inclusion of permanent canines and determination of the Canine Congestion Index®. Radiological retrospective study

This study is designed to demonstrate the interest in extracting temporary maxillary canines to facilitate the establishment of permanent canines in ectopic positions. On the basis of the results of our experience with 104 maxillary canines in ectopic positions in 58 patients aged 8–15 years, we recommend using temporary canines and radiological follow-up for a period of 18 months (interval of 6 months) with orthopantomograms to monitor the development of permanent canines (anteroposterior position, angle, and vertical position). We found an improvement in the positioning of the permanent canines through the extraction of deciduous canines in 87% cases. On the basis of these results, we devise an interception scored protocol of ectopic canines by extraction of deciduous canines with other inclusion criteria, which is defined as the Canine Crowding Index® . There is significant interest in avoiding included canines using an orthopantomogram, which is important for both the patient and the practitioner; this results in a decrease in treatment time, orthosurgical traction failures, and root resorption of the adjacent teeth.

3D Printing Assisted Autotransplantation of an Ectopic Canine

3D Printing Assisted Autotransplantation of an Ectopic Canine

A Mini Review on Orthodontic-Endodontic Management of Root Resorption Induced By Ectopic Canine

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Maxillary incisor root resorption induced by ectopic canines part 2: clinical management

There is extensive material in the orthodontic literature regarding canine ectopia but far less on the possible sequelae of ectopic canines, such as the resorption of maxillary incisor roots. This is the second paper in a two-part series exploring the subject of ectopic canines inducing root resorption of maxillary incisors. The first paper examined the orthodontic and dental literature in order to compile a review of the prevalence rates and longevity outcomes of maxillary incisor root resorption as a result of impacted maxillary canines. This second paper will explore the clinical management of patients with maxillary incisor resorption as a result of an impacted maxillary canine. Clinical Relevance: Maxillary incisor root resorption induced by ectopic maxillary canines is an issue for all dental specialties; however, the awareness of each stage of management is limited. This paper aims to increase awareness and provide a reference point for appropriate management by clinicians.

Maxillary incisor root resorption induced by ectopic canines part 1: prevalence rates and longevity outcomes

Root resorption of maxillary incisors as a result of impacted maxillary canines is a sequelae of canine ectopia that has been reported in the literature in terms of case reports and retrospective case series. However, to our knowledge there has been no work done that consolidates the available information on the subject, particularly since the advent of improved imaging techniques with higher rates of detection of maxillary incisor root resorption. This paper aims to review the prevalence rates of maxillary incisor root resorption induced by impacted maxillary canines, as well as to discuss the diagnosis and prognosis of teeth affected by this phenomenon. Clinical Relevance: Maxillary incisor root resorption induced by ectopic maxillary canines is an issue which may be encountered by all dental specialties; however, the awareness of each stage of management is frequently unknown by clinicians. This paper aims to increase awareness and provide a reference point for appropriate management.

Orthodontic treatment of a stubborn palatally ectopic canine: a case report

This is a case report that highlights a different treatment approach in dealing with palatally ectopic canines. The modified transpalatal arch with an 'active' arm was used to align a palatally ectopic canine with 'push' mechanics after the initial use of more conventional 'pull' mechanics (piggy-back archwire technique) had failed.

The management of palatally displaced maxillary canines: Considerations and challenges

This article opens with a recognition that ectopic maxillary canines may lead to frank impactions requiring a coordinated and multidisciplinary approach to their surgical/orthodontic management and the potential benefit of managing canine ectopia, particularly palatally displaced canines, more conservatively in their pre-eruptive ectopic positions in an effort to avoid impaction. The prevalence of palatally displaced canines (PDC) in various populations and corroborating as well as competing or conflicting opinions of etiology are briefly reviewed. Some of the traditional as well as relatively newer strategies and associated investigations of managing pre-eruptive palatally displaced maxillary canines are discussed, and the imaging techniques utilized to identify and locate ectopic maxillary canines are also discussed. Early detection of ectopic canines must include at the very least panoramic and/or periapical radiographs as part of any mixed dentition orthodontic examination and assessment. The sometimes unpredictable continued path of the ectopic maxillary canine poses clinical and ethical issues to the clinician when developing treatment strategies as part of any overall orthodontic treatment plan for young patients presenting with maxillary canine ectopia. The need for more thoughtful and carefully designed randomized clinical trials with a greater emphasis on subject sample scrutiny is strongly recommended to add much needed clarity to the clinical management of ectopic maxillary canines.

Periodontal status of ectopic canines after orthodontic treatment

To evaluate the periodontal health and tooth vitality of palatally impacted and buccal ectopic maxillary canines after completion of orthodontic treatment. Fifteen patients who had unilateral, palatally impacted canines and 15 patients who had unilateral, buccal ectopic canines comprised the subjects of the study. Clinical and radiographic data was collected by recalling the patients in both groups after a mean period of 3.82 ± 1.54 years following completion of their orthodontic treatment. In both groups, the contralateral, normally placed canines served as controls. Palatally impacted canines had greater pocket depths, higher gingival levels, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals. Buccal ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased clinical crown lengths, and higher electric pulp testing scores compared to their contralaterals. Buccal ectopic canines had lower electric pulp testing scores and higher bone levels compared to palatally impacted canines. All ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased crown lengths, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals.

Paired maxillary and smaller mandibular mouthguard for rugby player with malalignment

A rugby player who had frequently experienced soft tissue injuries while playing rugby and wearing a conventional custom-made mouthguard came to the hospital clinic. The patient had suffered traumatic soft tissue injuries such as lip lacerations and bite trauma. Severe crowding due to ectopic maxillary and mandibular canines was observed. In response to the patient's request for better protection, a set of maxillary and mandibular mouthguards was designed: one covering the entire maxillary dentition and the other the mandibular front teeth only. The mouthguards were to be worn simultaneously. In this paper, we describe how these mouthguards were fabricated and discuss the results. The patient has experienced no injury to the stomatognathic system, including the lips, for five seasons since he began wearing this set of mouthguards. This new pairing of mouthguards appears to offer sufficient protection against injury, despite severe malalignment. We believe that this new type of paired maxillary and mandibular mouthguards has the potential to reduce sports-related dental injuries.

Masculinization of the eruption pattern of permanent mandibular canines in opposite sex twin girls

The aim of this study is to explore the effect of prenatal androgenization on the clinical eruption of permanent teeth expressing dimorphism and bimaturism. The eruption curves of permanent teeth (except third molars), including those that make up the canine complex (permanent canines, lower first premolars), are compared among opposite sex twins (OS twins) relative to single-born boys and girls. The comparisons are made with regard to three phases of eruption (pierced mucosa, half- erupted, and completely erupted) from a cross-sectional sample of dental casts, using Kaplan-Meier survival and Cox regression analyzes. The casts were collected from 2159 school children from the US Collaborative Perinatal Project, including 39 pairs of OS-twins, of which 12 pairs (30.8%) were Euro-Americans and 27 pairs (69.2%) were of African-American ancestry. The eruption patterns of the incisors, upper first molars, and lower canines were found to be significantly masculinized (delayed) among OS twin girls. The differences in most other teeth were either not significant, or the number of observations of active eruption phases were too few, such as in the upper first molars and incisors, to yield strong evidence and meaningful results. The masculinization of the tooth eruption pattern in OS twin girls is intriguing because of the lower canine responses during puberty, as well as canine primordial formation during early fetal androgenization of their co-twin during the 8th to 14th gestational weeks. The present results offer a challenge for future research exploring tooth eruption mechanisms, and may also highlight some cases of delayed or ectopic canines, which are biased toward females.

Need for further clarity on optimal approach to ectopic canines

Randomised controlled trial. Patients between 8-13 years of age with either unilateral or bilateral PDC diagnosed on radiograph with the presence of mild crowding at the maxillary arch and/or molar relation showing Class II tendency were included. The head gear group (HG) used cervical pull headgear alone for one year for 12-14 hours a day, while the rapid maxillary expansion/headgear (RME/HG) group were treated with a banded rapid maxillary expander, (7 mm of active expansion; at the end of expansion all patients retained the expander for six months), followed by use of a cervical pull headgear as in the HG group. A control group received no active treatment. A successful outcome for PDC was defined as the full eruption of the tooth, thus permitting bracket positioning for final arch alignment at 18 months after the initial observation. Sixty of the 64 patients who entered the trial were available for final assessment. Successful eruption was 85.7% in the RME/HG group, 82.3% in the HG group and 36% in the control group. There was no statistically significant difference between the HG and RME/HG groups. The use of rapid maxillary expansion and headgear (or headgear alone) in PDC cases increases the success rate of eruption of the canine significantly (almost three times more than in untreated controls).

National clinical guidelines for management of the palatally ectopic maxillary canine

This review summarises updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). This guideline on the management of the palatally ectopic maxillary canine illustrates the information contained in the recently updated online version. The timely recognition of ectopic canines is important for the overall management of the dentition. This review illustrates five management strategies for ectopic permanent canines: interceptive treatment by extraction of the deciduous canine, surgical exposure and orthodontic alignment, surgical removal of the palatally ectopic permanent canine, auto-transplantation and no active treatment/leave and observe. The current available evidence for each of these management options has been evaluated and awarded a grade used by the Scottish Intercollegiate Guidelines Network.