The Management of Ectopic Canines
Dr. Trista Felty
Orthodontist, Abbotsford BC
Besides the third molar, canines are the most commonly impacted tooth in the mouth. 2% of the overall population will have impacted canines, 8% of which will be bilateral. The condition can occur on both the upper and lower arches, and it affects women approximately twice as frequently as men.
“Taking out the primary canine is quite an easy procedure. The potential benefit to opening the space for a canine that is tracking in the wrong direction outweighs the risk of losing a baby tooth.”
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team
Resources
- Extraction of primary canines for interceptive orthodontic treatment of palatally displaced permanent canines: A systematic review - PubMed (nih.gov)
- A randomized clinical study of two interceptive approaches to palatally displaced canines - PubMed (nih.gov)
- Preventive treatment of ectopically erupting maxillary permanent canines by extraction of deciduous canines and first molars: A randomized clinical trial - PubMed (nih.gov)
- Early treatment of palatally erupting maxillary canines by extraction of the primary canines - PubMed (nih.gov)
Thanks for the insights Dr. Felty! Very helpful as I feel my orthodontic knowledge is very lackluster.
Thanks for the beautiful slides!
I am a big fan of trying to expand to help eruption along with possibly pulling it down if necessary. There are excellent appliances to use to help avoid extraction. I have seen unilateral extractions that leave the dentition and smile in poor shape.
Hi there Dr Felty. I am an orthodontist from Halifax and enjoying your presentation very much. Notwithstanding, there two ages. That we as orthodontists have to be concerned with, when it comes to timing of treatment of potentially impacted permanent canine teeth. The first one is the chronological or birthdate age of the patient who is in our chair, and the second is the biological or dental age. In my experience, the biological/dental age can be ahead of or behind the chronological/birthdate age from a few months to as much as four years. This means that you can have a seven year old female patient in your chair who is biologically older than her ten year old brother., because her canine roots (dental age)is precocious and the canine want to erupt at eight, while her older chronological aged brother permanent canine roots are just starting to calcify. Because of this phenomenon that I have witnessed several times I would highly recommend that all seven year olds have a pan taken routinely in order to prevent the early developers from having impacted canines unnecessarily.and becoming crisis mgt patients at nine.
Also I do not agree that removing the deciduous canines is not the answer in many cases. The width of the permanent canine is approximately 9-10 mm in width ( m-d) while the width of the deciduous canine is 4.5 to 5 mm in width., plus there is not enough growth in that area to compensate for the difference . Also, for every 10 degrees of angulation of the canine, you need one mm of space in addition to the 10mm if the canine was parallel to the adjacent teeth. In those cases I would bracket the first permanent molars bilaterally along with bracketing the anterior teeth and insert an .016 SS bypass arch wire to distalize the d’s. e’s and 6’s BEFORE the roots commence their development/calcification on the second permanent molar teeth! I have treated literally hundreds of cases successfully using the very unique technique., in order to avoid the unnecessary extraction of permanent teeth and to salvage the potentially impacted permanent canine teeth. You need to read add Don Enlows book on growth and development as well as Dr Arne Bjork’s book on growth and development using implants back in the early 60’s.. if you wish to call or text me I can be reachyat 1992 49@-4671 or email me at jensenortho@eastlink.ca. I graduated from Dalhousie in 1968, worked in northern BC as a dental extern then we to U of Manitoba for my MSc and my Dip in Ortho and kater my FRCD while I was an associate prof at Dal a d senior orthodontic consultant at three hospitals on the Cleft Palate Team, Bd on the orthognathic surgical team in two hospital hospitals fo 17 years. Also went across the country and in the USA giving lectures on cleft palates ortho and orthognathic orthognathic and TMJ orthodontics. Just passed my fiftieth year of practice after treating over 16,000 patients and still counting. and still enjoying it! lOL ?
Warmest Regards
Dr Gene Jensen
DDS, MSc. FRCD(C), Dip in Ortho., Assoc Prof of Ortho (retired), Commercial Ships Captain,, large sailing Yacht designer and builder, orthodontic office designer. Unique home designer, blue water sailor and racer, ex longshoremen and steeplejack and climber