Maxillary canine displacement; further twists in the tale

Abstract

This report describes two cases seen over a 5-year period, each with a labially impacted maxillary canine found in close proximity to the adjacent first permanent premolar, which had a deviated palatal root. The issue as to whether the premolar root deviation either produced the canine impaction or vice versa is discussed, both with reference to the processes considered to be involved in normal tooth eruption, and to three previously published similar cases.

Endodontic Surgery of a Deviated Premolar Root in the Surgical Orthodontic Management of an Impacted Maxillary Canine

“…Of these 7 cases, 2 male patients and 1 female patient had palatal impactions (22,25), and 3 female patients and 1 male patient had labial impactions (23,24,26). In our case, the female patient showed palatal impaction of the left maxillary permanent canine.…”

“…Chate (23,24) reports some remaining ambiguity as to the causes of impaction for male patients; however, for female patients, he suggests the impactions cause the root deviations.…”

“…In the absence of crowding, the deviated palatal premolar root was either surgically resected after endodontic treatment or orthodontically rotated out of the way for alignment of the impacted canine (22,25,26). Another approach was the surgical removal of the permanent canine, while the primary canine was retained (23).…”

“…To date, a total of 7 cases have been described where impacted maxillary canines were found in close proximity to a deviated root of the adjacent first premolar (22)(23)(24)(25).…”

“…The authors of these labial or palatal impaction cases showed different clinical approaches (orthodontic, orthodontic-surgical extrusion, and surgical removal of deviated premolar root) for the resolution of these impacted canines (22,23,25,26). However, no data are reported about the approach in these cases by endodontic…”