Copyright (c) Department of Orthodontics University of Dental Medicine, Yangon

1. Buccally erupted maxillary canine
PROF Dr Hla Hla Yee

2. ●Causes
1- Crowding
- Maxillary canine is usually the last tooth to erupt anterior
to the first permanent molar.
If the upper arch is crowded , maxillary canine may be
squeezed buccal to it normal position.
2- Retention of primary canine
3- Supernumerary teeth

5. Totally blocked out buccally erupted maxillary canines

8. Investigations
Dental panoramic tomogram
- To provide a general view of the developing
dentition and
- To confirm the present and position of all
unerupted permanent teeth.

9. Figure –
Maxillary permanent canines palpable in the buccal sulcus.
The canine position is given away by the inclination of the
permanent lateral incisor crowns.

10. Possible means for creating space for correction of
crowding
1-Enamel stripping (Disking )
2-Arch expansion
3-Distal movement of molars
4-Extraction
5-Any combination of the above

11. Transposition of maxillary canine
- In the maxillary canine is usually transposed with first
premolar and in the mandible lateral incisor is more
commonly involved.
Treatment options
-Alignment of teeth in transposed position.
-Extraction of the most displaced tooth ,
-Treat the other orthodontic problems

12. Transposition 3 (Ectopic erupted 3)

13. Transposition 3 and retained c

14. Palatally displaced maxillary canine or
palatal canine
Possible causes
1- Genetic.
2- Crypt displacement .
3- Maxillary canine has the longest path of eruption of any
permanent tooth.
4- Arch length discrepancy.
5- Trauma to the maxillary anterior area at an early stage of
development .
6- Peg shaped , short rooted upper lateral incisors or absent 2’s -
---- guidance for maxillary canine is reduced .
7- Class II div: 2 malocclusion.
Dr Hla Hla Yee

15. Retained c and palatally erupted 3

16. Peg shaped 2s
Retained c and palatally displaced canine

17. Palatally erupted maxillary canines

18. Aims of treatment
- Relief of crowding
- Upper and lower arch alignment
- Correction of molar relationship
- Closure of any residual apace

19. Investigations
1- Clinical
- Palpation of the buccal sulci and palatal mucosa in
upper canine regions , as well as observation of the
2 inclination , usually provide a reasonable
guide to the probable position of an unerupted 3 .
-Labial displacement of 2 crown indicate 3 to be lying
high and buccal over 2 root or low and palatal.

20. 2 - Radiographic – to assess :
- The root length of c
- The vertical and mesiodistal position relative to the incisor
roots.
- The axial inclination.
- The apex location.
- The location of unerupted 3s.
● By using –OPG view
- Parallax view
- Periapical view ect.

21. Management option for palatally displaced
unerupted canines
1-Interceptive extraction of c in mixed dentition.
2-Maintain c and keep unerupted canine under radiographic
review.
3-No treatment , if 2 and 4 are in contact and appearance is
satisfactory or if patient refuses other options .Again 3 will
require removal in due course .

22. 4- Exposure and orthodontic alignment only feasiable
if ;
a –maxillary canine in favourable position for orthodontic
alignment;
b - sufficient space available for 3 or can be created.
C- patient willing to undergo surgery and prolong
orthodontic treatment ( usually 2+ years )

23. 5 – Transplant 3
- Adequate space in arch for 3
- Intact removal of 3 possible
- Adequate buccal / palatal bone.
Prognosis best :
- if root of is 50-75% formed ,
- minimal handing of 3 root at surgery and
- rigid splinting is avoided.

24. However , shorter splint times (1 or 2 weeks ) and R.C.T for
teeth with closed apices within 3 weeks of transplantation
may good prognosis.

25. Retained c and palatally erupted 3

26. Choice of teeth for extraction for correction of crowding - ?