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• The best results are achieved if there is good contact
between the lateral incisor and first premolar. 1,4
• It is indicated in patients willing to undergo
orthodontic treatment to substitute the first premolar
for the canine. 1,4
• The possible risk of damaging the roots of adjacent
teeth during the surgical removal of the impacted
canine should be assessed and discussed with the
patient. 1
Auto-transplantation
• This treatment option should be considered
if the patient is unwilling to wear orthodontic
appliances. 1,4
• Transplantation is indicated where interceptive
extraction of the deciduous canine has failed or
is unsuitable, and exposure and alignment of the
impacted canine is not possible. 1,4
• There should be adequate space available for the
canine and sufficient alveolar bone to accept the
transplanted tooth. 1,4
• The prognosis should be good if the canine to be
transplanted shows no evidence of ankylosis. 1
• The best results are achieved if the impacted canine
can be removed atraumatically. 1,4
• Depending on the stage of root formation (more
than 3/4 of the root formed) the transplanted canine
may require root canal therapy to be commenced
within ten days following transplantation. 1
No treatment and continuous monitoring
• The patient does not want treatment or is happy with
their dental appearance. 1,4
• There should be no evidence of root resorption of
adjacent teeth or other pathology. 1
• There should be good contact between the lateral
incisor and first premolar or the deciduous canine
should have a good prognosis. 1,4
• Severely displaced palatally impacted canines with no
evidence of pathology may be left in-situ, particularly if
the canine is remote from the dentition. 1
• Impacted canines left in-situ necessitate
radiographic monitoring to check for cystic changes
or root resorption. 1,4
• Regular review to ensure that the impacted canine
does not pose any risk to the adjacent structures. 1,4
References
1. Management of the palatally ectopic maxillary canine, Husain
J. et al., Publication of the Royal College of Surgeons, Faculty of
Dental Surgery, online publication, updated March 2010.
2. A review of the diagnosis and management of impacted
maxillary canines, Bedoya M. and Park J., The Journal of the
American Dental association (JADA). 2009;140:12:1485-93.
3. Managing the maxillary canine: 1. Diagnosis, localization
and interceptive treatment, McIntyre G., Orthodontic Update,
January 2008;1:7-15.
4. Clinical Practice Guidelines, The management of the palatally
ectopic canine, Ministry of Health Malaysia, September 2004.
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| 42 | Smile Dental Journal | Volume 6, Issue 4 - 2011