Prediction of maxillary canine impaction using eruption pathway and angular measurement on panoramic radiographs

Abstract

Objectives To compare the normal eruption pattern and angulation in impacted maxillary canines using panoramic radiographs to predict maxillary canine impaction. Materials and Methods Patients aged 6 to 15 years were classified into the normal eruption group (n = 229) and the impaction group (n = 191). At least two panoramic radiographs were taken in the normal eruption group during the eruption process of the maxillary canine. The growth pattern of the maxillary canine was analyzed using an XY coordinate system, with the tip of the maxillary lateral incisor as the origin and the tooth's long axis as the Y-axis and measurement of the relative position of the crown tip and angulation of the maxillary canine. Results The crown tips of normally erupted maxillary canines were intensively distributed along the distal surface of the maxillary lateral incisor, while those of impacted canines were widely distributed. The angulations of the normally erupted canines increased as eruption increased along the lateral incisor and then decreased at the cervical point of the lateral incisor. The angulations of the impacted canines were scattered, with no uniform pattern. Conclusions While using the normal eruption path of the maxillary canine and the pattern of change in angulation based on the distal surface of the maxillary lateral incisor, early intervention or regular follow-up is needed to prevent maxillary canine impaction.

Normal pre-eruptive inclinations of maxillary canine, lateral incisor, and first premolar in children aged 6–14 years

“…Most of the studies[ 15 26 27 28 ] which evaluated the eruptive movement of canine, first premolar, and lateral incisor are retrospective, and no study has evaluated the normal pre-eruptive angulations of the canine, lateral incisor, and first premolar during 6–12 years of age. In this study, orthopantomograph, which is a two-dimensional image of a three-dimensional object, was used.…”

“…Shin et al . [ 28 ] also stated that the angle between the canine and the lateral incisor in a normal erupting canine will first increase and then decrease as the canine approaches the cervical area of the lateral incisor. This results in the ugly duckling stage and will self-correct after the canine has fully erupted into the oral cavity.…”

Evaluation of Mesiodistal Root Angulation of Permanent Incisors, Canines, and First Pre-Molars by Orthopantomogram Dental Imaging Findings in 296 Children Aged 6-14 Years

“…Most studies [ 8 , 15 , 25 , 26 ] that evaluated the eruptive movement of canine, first premolar, and lateral incisor were retrospective, and no study has evaluated the normal pre-eruptive angulations of the C, LI, and FP in children aged 6–12 years. In the present study, orthopantomography [ 15 ] was used, which is a two-dimensional image of a three-dimensional object.…”

“…Shin et al [ 26 ] also stated that the angle between C and LI in a normal erupting C will first increase and then decrease as the C approaches the cervical area of the LI. This results in the “ugly duckling” stage and will self-correct after the C has fully erupted into the oral cavity.…”

Factors Contributing to Canine Impaction in Patients With Unilateral Cleft Lip and Palate Undergoing Alveolar Bone Grafts

“…Another study of 87 patients with UCLP reported congenital absence of the permanent lateral incisor on the cleft side in 48.8% of patients (Tortora et al, 2008). Canine angulation has also been noted as an indicator for canine impaction risk, with one study reporting a higher risk for permanent canines angled greater than 30 degrees from the long axis of the lateral incisor in noncleft populations (Shin et al, 2022). A recent study evaluating a cohort of males with UCLP found a higher incidence of canine impaction in patients with missing laterals and canine angulations greater than 25 degrees relative to the midsagittal plane (Hong et al, 2022).…”