This article reviews the aetiology and management of the ectopic maxillary canine. Much controversy surrounds the causes of canine palatal ectopia. The recent evidence surrounding the genetic and guidance theories are examined. The management options are detailed and the indications for each treatment modality based on the available scientific evidence are presented. Finally, the untoward sequelae of canine ectopia are discussed.
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References
1.
AltonenM. and MyllarniemiS. (1976) Results of surgical exposure of impacted cuspids and bicuspids in relation to patients' somatic and dental maturation, International Journal of Oral Surgery, 5, 180–186.
2.
AndreasenJ. O. (1987) Ectopic eruption of permanent canines eliciting resorption of incisors: treatment by autotransplantation, Tandb'gbladet, 91, 487–492.
3.
AndreasenJ. O. (1992) Atlas of Replantation and Transplantation of Teeth, Mediglobe S A, Fribourg.
4.
BeckerA., SmithP. and BeharR. (1981) The incidence of anomalous maxillary incisors in relation to palatally displaced cuspids, Angle Orthodontist, 51, 24–29.
5.
BeckerA., KokaviD. and ZilbermannY. (1983) Periodontal status following alignment of palatally impacted canine teeth, American Journal of Orthodontics, 84, 332–336.
6.
BeckerA., ZilbermannY. and TsurB. (1984) Root length of lateral incisors adjacent to palatally displaced maxillary cuspids, Angle Orthodontist, 54, 218–225.
7.
BeckerA., ShpackN. and ShteyerA. (1996) Attachment bonding to impacted teeth at the time of surgical exposure, European Journal of Orthodontics, 18, 457–463
8.
BennettJ. and McLaughlinR. (1997) Orthodontic Management of the Dentition with the Preadjusted Appliance, Isis Medical Media, Oxford.
9.
BerglundL., KurolJ. and KvintS. (1996) Orthodontic pretreatment prior to autotransplantation of palatally impacted maxillary canines: case reports on a new approach, European Journal of Orthodontics, 18, 449–456.
10.
BisharaS. (1994) Impacted maxillary canines: a review, American Journal of Orthodontics and Dentofacial Orthopedics, 101, 159–171.
11.
BisharaS., KommerD. D., Mc NeillM. H., MontaganoL. H., OesterleL. H. and YoungqvistH. W. (1976) Management of impacted maxillary canines. American Journal of Orthodontics, 69, 371–387.
12.
BjerklinK., GleerupA. and KurolJ. (1992) Long term effects in children with ectopic eruption of the maxillary first permanent molars, European Journal of Orthodontics, 17, 293–304.
13.
BrenchleyZ. and OliverR. G. (1997) Morphology of anterior teeth associated with displaced canines, British Journal of Orthodontics, 24, 41–45.
14.
BrinI., SolomonY. and ZilbermannY. (1993) Trauma as a possible etiologic factor in maxillary canine impaction, American Journal of Orthodontics and Dentofacial Orthopedics, 104, 132–137.
15.
BroadbentB. H. (1941) Ontogenic development of occlusion, Angle Orthodontist, 11, 223–241.
16.
BrownL. H., BerkmanS., CohenD., KaplanA. L. and RosenbergM. (1982) A radiological study of the frequency and distribution of impacted teeth, Journal of the Dental Association of South Africa, 37, 627–630
17.
CoulterJ. and RichardsonA. (1997) Normal eruption of the maxillary canine quantified in three dimensions, European Journal of Orthodontics, 18, 449–456.
18.
DachiS. F. and HowellF. V. (1961) A survey of 3874 routine full mouth radiographs, Oral Surgery, Oral Medicine, Oral Pathology, 14, 1165–1169.
19.
DarendelilerM. A. and FriedliJ. M. (1994) Case report. Treatment of an impacted canine with magnets, Journal of Clinical Orthodontics, 28, 639–643.
20.
EricsonS. and KurolJ. (1986a) Longitudinal study and analysis of clinical supervision of the maxillary canine eruption, Community Dentistry and Oral Epidemiology, 14, 172–176.
21.
EricsonS. and KurolJ. (1986b) Radiographic assessment of maxillary canine eruption in children with signs of eruption disturbance, European Journal of Orthodontics, 8, 133–140.
22.
EricsonS. and KurolJ. (1987a) Incisor resorption caused by maxillary cuspids. A radiographic study, Angle Orthodontist, 57, 332–346.
23.
EricsonS. and KurolJ. (1987b) Radiographic examination of ectopically erupting maxillary canines, American Journal of Orthodontics, 91, 483–492.
24.
EricsonS. and KurolJ. (1988a) Early treatment of palatally erupting maxillary canines by extraction of primary canines, European Journal of Orthodontics, 10, 283–295.
25.
EricsonS. and KurolJ. (1988b) CT diagnosis of ectopically erupting maxillary canines-a case report, European Journal of Orthodontics, 10, 115–120.
26.
EricsonS. and KurolJ. (1988c) Resorption of maxillary lateral incisors caused by ectopic eruption of the canines. A clinical and radiographic analysis of predisposing factors, American Journal of Orthodontics and Dentofacial Orthopedics, 84, 503–513.
27.
FoxN. A., FletcherG. A. and HornerK. (1995) Localizing maxillary canines using dental panoramic radiography, British Dental Journal, 179, 416–420.
28.
GallowayI. and StirrupsD. R. (1989) The effect of age at diagnosis on complexity and outcome of treatment of palatally ectopic canines, British Journal of Orthodontics, 16, 87–92.
29.
GroverP. S. and LortonL. (1985) The incidence of unerupted permanent teeth and related clinical cases, Oral Surgery, Oral Medicine, Oral Pathology59, 420–429.
30.
HarzerW., SeifertD. and MahdiY. (1994) The orthodontic classification of impacted canines with special reference to the age at treatment, the angulation and the dynamic occlusion, Fortschritte der Kieferorthopädie/ Journal of Orofacial Orthopedics, 55, 47–53.
31.
HitchinA. D. (1956) The impacted maxillary canine, British Dental Journal, 100, 1–14.
32.
HultgrenB. W., IsaacsonR. J. and FrenschP. A. (1994) A case for specialty practice. Does practice make perfect. or permanent? Angle Orthodontist, 64, 231–237.
33.
HunterS. B. (1983) Treatment of the unerupted maxillary canine. Part 2 Orthodontic methods, British Dental Journal, 154, 324-326.
34.
HurmeV. O. (1949) Ranges of normalcy in the eruption of permanent teeth, Journal of Dentistry for Children, 16, 11–15.
35.
JacobyH. (1979) The ‘Ballista Spring’ system for impacted teeth, American Journal of Orthodontics, 75, 143–151.
36.
JacobyH. (1983) The etiology of mwdllary canine impactions, American Journal of Orthodontics, 83, 125–132.
37.
KettleM. A. (1957) Treatment of the unerupted maxillary canine, Transactions of the British Society for the Study of Orthodontics, pp. 74–87.
38.
KohaviD., BeckerA. and ZilbermannY. (1984) Surgical exposure, orthodontic movement and final tooth position as factors in periodontal breakdown of treated palatally impacted canines, American Journal of Orthodontics, 85, 72–77.
39.
KokichV. G. and MatthewsD. P. (1993) Surgical and orthodontic management of impacted teeth, Dental Clinics of North America, 37, 181–204
40.
KristersonL. (1985) Autotransplantation of human premolars, International Journal of Oral Surgery, 14, 200–213.
41.
KuftinecM. M., StomD. and ShapiraY. (1995) The impacted maxillary canine. II. Clinical approaches and solutions, Journal of Dentistry for Children, 52, 325–340.
42.
KurolJ., EricsonS. and AndreasenJ. O. (1997) The impacted maxillary canine, In: Textbook and Color Atlas of Tooth Impactions, (ed. AndreasonJ. O.) Munksgaard, Copenhagen, pp. 124-164
43.
MachenD. E. (1989) Legal aspects of orthodontic practice: risk management concepts. The impacted canine, American Journal of Orthodontics and Dentofacial Orthopedics, 96, 270–271.
44.
McSherryP. F. (1996) The assessment of and treatment options for the buried maxillary canine, Dental Update, 23, 7–10.
45.
McSherryP. F. and RichardsonA. (1998) Ectopic eruption of the maxillary canine quantified in three dimensions on cephalometric radiographs between the ages of 5 and 15 years, European Journal of Orthodontics (in press).
46.
MillerB. H. (1963) The influence of congenitally missing teeth on the eruption of the upper canine, Transactions of the British Society for the Study of Orthodontics, pp. 17–24.
47.
MossJ. P. (1972) The unerupted canine, Dental Practitioner, 22, 241–248.
48.
MossJ. P. (1974) The indications for transplantation of the maxillary canine in the light of 100 cases, British Journal of Oral Surgery, 12, 268–274.
49.
MosseyP. A., CampbellH. M. and LuffinghamJ. K. (1994) The palatal canine and the adjacent lateral incisor: a study of a West of Scotland population, British Journal of Orthodontics, 21, 169–174.
50.
MourshedF. (1964) A roentgenographic study of dentigerous cysts I. Incidence in a population sample, Oral Surgery, Oral Medicine, Oral Pathology, 18, 47–53.
51.
OliverR. G, MannionJ. E. and RobinsonJ. M. (1989) Morphology of the maxillary lateral incisor in cases of unilateral impaction of the maxillary canine, British Journal of Orthodontics, 16, 9–16.
52.
OrtonH. S., GarveyM. T. and PearsonM. H. (1995) Extrusion of the ectopic maxillary canine using a lower removable appliance, American Journal of Orthodontics and Dentofacial Orthopedics, 107, 349–359.
53.
PeckS., PeckL. and KatajaM. (1994) The palatally displaced canine as a dental anomaly of genetic origin, Angle Orthodontist, 64, 249–256.
54.
PirinenS., ArteS. and ApajalahtiS. (1996) Palatal displacement of canine is genetic and related to congenital absence of teeth, Journal of Dental Research, 75, 1742–1746.
55.
PostletwaiteK. M. (1989) Resorption of premolar roots by ectopic canines, British Dental Journal, 167, 397–398.
56.
PowerS. M. and ShortM. B. E. (1993) An investigation into the response of palatally displaced canines to the removal of deciduous canines and an assessment of factors contributing to favourable eruption, British Journal of Orthodontics, 20, 215–223.
57.
RayneJ. (1969) The unerupted maxillary canine, Dental Practitioner, 19, 194–204.
58.
RimesR. J., MitchellC. N. T. and WillmotD. R. (1997) Maxillary incisor root resorption in relation to the ectopic canine: a review of 26 patients, European Journal of Orthodontics, 19, 79–84.
59.
Roberts-HarryD and HarradineN. (1995) A sectional approach to the alignment of ectopic maxillary canines. British Journal of Orthodontics, 22, 67–70.
60.
SandlerP. J., MeghjiS., MurrayA. M., SpringateS. D., SandyJ. R., CrowV. and ReedR. T. (1989) Magnets and orthodontics, British Journal of Orthodontics. 16, 243–249.
61.
SasakuraH., YoshidaT., MurayamaS., HanadaK. and NakajimaT. (1984) Root resorption of the upper permanent incisor caused by the impacted canine, International Journal of Oral Surgery, 13. 299–306.
62.
SchatzJ. P., ByloffF., BernhardJ. P. and JohoJ. P. (1992) Severely impacted canines: autotransplantation as an alternative, International Journal of Adult Orthodontics and Orthognathic Surgery, 7, 45–52
63.
SchmuthG. P., FreisfeilM., KosterO. and SchullerH. (1992) The application of computerized tomography (CT) in cases of impacted maxillary canines, European Journal of Orthodontics, 14, 296–301.
64.
SembG. and SchwartzO. (1997) The impacted tooth in patients with alveolar clefts, In: Textbook and Color Atlas of Tooth Impactions, (ed. AndreasonJ. O.) Munksgaard, Copenhagen, pp. 331-348
65.
ShahR. M., BoydM. A. and VakilT. F. (1978) Studies of permanent tooth anomalies in 7886 Canadian individuals, Journal of the Canadian Dental Association, 44, 262–264.
66.
SouthallP. and GravelyJ. (1987) Radiographic localization of unerupted teeth in the anterior part of the maxilla: a survey of the methods currently employed, British Journal of Orthodontics, 14, 235–242.
67.
ThilanderB. and JacobssonS. O. (1968) Local factors in impaction of maxillary canines, Acta Odontologica Scandinavica, 26, 145–168.
68.
UsiskinL. A. (1991) Management of the palatal ectopic and unerupted maxillary canine, British Journal of Orthodontics, 18, 339–346.
69.
VanarsdallR. L. and CornH. (1977) Soft tissue management of labially positioned unerupted teeth, American Journal of Orthodontics, 72, 53–77.
70.
VermetteM. E., KokichV. G. and KennedyD. B. (1995) Uncovering labially impacted teeth: apically positioned flap and closed eruption techniques, Angle Orthodontist, 65, 23–32.
71.
WoloshynH., ArtunJ., KennedyD. B. and JoondephD. R. (1994) Pulpal and periodontal reactions to orthodontic alignment of palatally impacted canines, Angle Orthodontist, 64, 257–264.
72.
Wong LeeT. K. and WongF. C. (1985) Maintaining an ideal tooth gingiva relationship when exposing and aligning an impacted tooth, British Journal of Orthodontics, 12, 189–192.
73.
ZachrissonB. U. and ThilanderB. (1985) Introduction to Orthodontics, 5th edn, Tandläkaförlaget Stockholm, p. 176.
74.
ZilbermanY., CohenB. and BeckerA. (1990) Familial trends in palatal canines, anomalous lateral incisors, and related phenomena, European Journal of Orthodontics, 12, 135–139.
