Different Management Approaches in Impacted Maxillary Canines: An Overview on Current Trends and Literature

Abstract

Aim: This study aimed to overview and collect the current trends and techniques in managing maxillary impacted canines by retrieving recent literature, in a chronological manner from the prevention to the very late stages of treatment in adults. Background: We performed a review on the recent literature regarding the current trends on the management of impacted canines. We have researched various types of available articles such as clinical trials and case presentations, meta-and systematic analyses, and literature reviews focusing on clinical management of impacted canines and their outcome evaluations. We adhered to those articles published within the last decade with a focus on treatment planning for impacted and displaced canines. Review results: Depending on the diagnosis and its timing of it, a maxillary impacted canine can be managed by either prevention or interception, surgical opening followed by autonomous eruption or orthodontically traction, autotransplantation, and at last by removal and space closure. These techniques are elaborated one by one according to the age and severity of the diagnosis. Conclusion: Impaction of the canines is a manageable abnormality which is highly dependent on the timing and localization of the displaced tooth. Early detection will give the upper hand to orthodontists to engage by either prevention through extraction of deciduous canines or intercepting via assistant devices to create more space. According to the clinical situation, open or closed surgical uncovering might be required to bond an attachment. However, generally, those techniques did not show any significant clinical distinction in the outcome assessments. Clinical significance: These approaches are highly technique sensitive and require collaborations with other specialties. Proper diagnosis and prognosis assessment are necessary before making any decision to bring an impacted canine in alignment.

Treatment of impacted canines with aligners: An alternative and viable option

“…Canine‐forced eruption technique with surgery closed approach has been widely described in the literature, but it has been never associated with aligners and with elastics activation system managed directly by patient. In every device described in the literature are present fixed appliance and/or anchorage system that preview an additional surgery phase for insertion of miniscrews or plates 23‐26,28 . Our system is clearly less invasive and it guarantees esthetic and less stress for the patient who can decide during the day when is the best time to wear elastics for extruding impacted canines.…”

“…In every device described in the literature are present fixed appliance and/or anchorage system that preview an additional surgery phase for insertion of miniscrews or plates. 23 , 24 , 25 , 26 , 28 Our system is clearly less invasive and it guarantees esthetic and less stress for the patient who can decide during the day when is the best time to wear elastics for extruding impacted canines.…”

Impacted Palatal Canines and Diode Laser Surgery: A Case Report

“…The choice of treatment in the patient with an impacted canine changes with the age, oral health, and etiologic factors [ 3 , 12 ]: monitoring of the impacted element, in the absence of clinical problems [ 13 ], extraction of the deciduous element, if the impacted permanent canine is close to eruption [ 3 ], extraction of the deciduous tooth and simultaneous uncovering of the permanent tooth with the application of an orthodontic appliance to increase the space in the arch, and allowing the physiological eruption of the canine [ 13 ]. In some cases, it is possible to perform dental reimplantation, when the orthodontic treatment turns out to be too complex, unsuccessful, or not accepted by the patient [ 13 ].…”

Management of maxillary impacted canines: A prospective study of orthodontists' preferences

“…Other approaches that might suit older children and adults include surgical exposure (which can be done with or without orthodontic traction), transplantation, and extraction of the MIC. The appropriate choice depends on treatment duration, complexity, esthetic results, functional outcomes, and complications ( Grisar et al, 2020 , Izadikhah et al, 2020 ). Orthodontic traction of ectopic canines can lead to root resorption and alveolar bone loss of the canines and adjacent teeth.…”