This document discusses canine impaction, which occurs in approximately 2% of the population and is more common in females and in the maxilla. The most common types of impaction involve the third molars, canines, and second premolars. Canine impaction is classified based on its location. Treatment depends on factors like symptoms, root development, and space availability and may include no treatment, interceptive removal, surgical exposure with orthodontics, surgical repositioning, or extraction.
2. IMPACTION
• An impacted tooth is the one that fails to erupt into the
dental arch within the usual range of expected time.
• Most common impacted teeth:
Mandibular third molars
Maxillary third molars
Maxillary canines
Mandibular second premolars
3. CANINE IMPACTION
• Maxillary canine impaction occurs in approximately 2% of
the population and is twice as common in females as it is
in males
• The incidence of canine impaction in the maxilla is more
than twice that in the mandible
• Of all patients who have impacted maxillary canines, 8%
have bilateral impactions
4. CANINE IMPACTION CLASSIFICATION
(ARCHER)
Class I
• Palatal impacted canine loacted in the palate
Class II
• Buccal / labial impacted canine located either on bucaal or labial surface of
maxilla
Class III
• Bucco-palatal / palato-buccal half palatal half buccal (crown on palatal side & root
of buccal side vice versa)
Class IV
• Vertical between lateral incisors & first premolars
Class V
• Impaction in edentulous arch
5. ETIOLOGY
Arch length discrepency lack of space
Failure of root resorption of primary canine
Early loss of primary canine
Ankylosed permanent canine
Resistance to eruption of canine
More prone to displacement/misdirection
Cyst or neoplasm associated with the permanent canine
Absence of maxillary lateral incisor guidance theory
Genetic alveolar cleft
Trauma to anterior maxilla
7. COMPLICATIONS DUE TO IMPACTED
CANINE
Adjacent teeth
may undergo
internal or
external
resorption
Change in the
alignment of
lateral incisor
Odontogenic
cyst formation
Development
of
odontogenic
tumor
9. 1. History
• Age
• History of trauma
• Family history
2. Clinical examination
• Delayed eruption of permanent canine
• Retained primary canine
• Absence of canine buldge
• Presence of buldge palatally
• Incisor tipped/migrated distally
• Space available
• Increased mobility of adjacent tooth
11. MANAGEMENT
No treatment (leave in situ)
• If canine not causing any problem
• Cannot do orthodontic traction
• Deciduous tooth properly positioned
• Systemic problems
• Highly dense bone e.g. osteoporosis
• No root resorption of adjacent teeth / no pathologies
• No pain
• Patient not willing
• Periodic radiographic evaluations for pathological changes
12. Interceptive treatment
• Interceptive removal of deciduous canine to enhance the eruption of
permanent canine is done when the root has not formed complelely
and space is available for eruption
• Extraction of primary canines by age 8-9 yrs
• If the crown of canine is distal to the midline of lateral incisors the
canine will erupt in its position 91% cases
• If the crown is mesial to the midline of the lateral incisors then 64%
will erupt in its position
13. Surgical exposure with orthodontic alignment
• Salvaging a bone impacted canine requires a combination of both surgical and
orthodontic management
• Done when tooth does not erupt spontaneously after creating the space in arch
• Done 6 months after root formation
14. Surgical repositioning / auto transplantation
• It refers to the repositioning of an autogenous erupted or
unerupted tooth from one site to another in the same individual
• Malpositioned impacted canine but a favourable root pattern
• Impacted canine extracted surgically
• Socket created at donor side (the socket of deciduous canine or
first premolar depending on the mouth of space available)
• Tooth re-implanted
15. Surgical extraction
• Symptomatic and can not be corrected orthodontically
• Dilacerated root, ankylosed canine, causing root resorption, severely
displaced
• Transplantation cant be done
1. Labial approach
2. Palatal approach
