Radiographic examination of ectopically erupting maxillary canines

What is the value of orthodontic treatment?

“…Palatally displaced maxillary canines are present in about 2% of the population 19 and a significant percentage cause root resorption of the adjacent incisors. When using plain radiographic films, root resorption was found to be present in about 12% of people with palatally displaced maxillary canines; 20 however the prevalence of root resorption was found to be much higher when investigated using cone beam CT. 2 The ultimate sequelae of severe root resorption is mobility and possible loss of the affected teeth if left untreated; however if the ectopic tooth is diagnosed early enough, intervention in the form of surgical exposure of the impacted tooth and orthodontic mechanical traction can prevent this and is usually very successful. If root resorption is present on the adjacent incisors, by moving the ectopic canine away from the teeth, there is cessation of the resorptive process and even incisors with very short roots have been shown to be functionally viable many years later.…”

Periodontal health of palatally displaced canines treated with open or closed surgical technique: A multicenter, randomized controlled trial

“…1 The majority of ectopic canines are palatally displaced 2 and treatment can be complex, time consuming and expensive for both the patient and health care system. Whereas orthodontic treatment has been found to be mildly detrimental to the periodontium, 3 case reports have described severe periodontal destruction in some cases of aligned palatally displaced canines (PDC).…”

3 '2' 1: Orthodontic re-positioning of canines into central incisors

“…27 Resorption is usually asymptomatic 20,28 and found in 12% of incisors adjoining ectopic maxillary canines giving an overall prevalence of 0.7% in 10-13-year-olds. 2 A correlation has not been found between age, gender and resorption 4 although cases of central and lateral incisor resorption seem to be more common in boys than girls. 19 The most common age of resorption is at 11-12 years old.…”

“…23 It is also important to note that there is a degree of overlapping in 45% of cases where the canine is assessed by means of intraoral radiographs and a CBCT not only shows the resorption but also other lesions which are not always detected on intraoral radiographs. 2 Despite the many advantages, however, the large radiation dose of CBCT must always be considered and careful selection criteria are required. A large volume CBCT can have an effective dose of up to 368 µSv 24 …”

“…Impacted canines are more prevalent in female patients with a ratio of 2:1 and most impactions (80%-92.6%) are palatal as opposed to buccal. 2,3 No difference has been found in the frequency of occurrence of the right and left maxillary canines. 4 …”