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References

Thilander B, Myrberg N. The prevalence of malocclusion in Swedish schoolchildren. Scand J Dent Res. 1973; 81:12-21 https://doi.org/10.1111/j.1600-0722.1973.tb01489.x
Stivaros N, Mandall NA. Radiographic factors affecting the management of impacted upper permanent canines. J Orthod. 2000; 27:169-173 https://doi.org/10.1093/ortho/27.2.169
Peck S. Misleading article on palatally displaced canines. Am J Orthod Dentofacial Orthop. 2016; 149:149-150 https://doi.org/10.1016/j.ajodo.2015.11.016
Becker A, Chaushu S. Authors' response. Am J Orthod Dentofacial Orthop. 2016; 149:150-151 https://doi.org/10.1016/j.ajodo.2015.11.015
Management of the palatally ectopic maxillary canine. http://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/clinical-guidelines/ (accessed June 2022)
Ericson S, Kurol PJ. Resorption of incisors after ectopic eruption of maxillary canines: a CT study. Angle Orthod. 2000; 70:415-423
McIntyre GT. Managing the maxillary canine: 2. Treatment options for impacted permanent maxillary canines. Orthod Update. 2008; 1:33-48
Olive RJ. Orthodontic treatment of palatally impacted maxillary canines. Aust Orthod J. 2002; 18:64-70
Alessandri Bonetti G, Incerti Parenti S, Zanarini M, Marini I. Double vs single primary teeth extraction approach as prevention of permanent maxillary canines ectopic eruption. Pediatr Dent. 2010; 32:407-412
Double vs single primary tooth extraction in interceptive treatment of palatally displaced canines. Angle Orthod. 2020; 90:751-757 https://doi.org/10.2319/031920-196.1
Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. Eur J Orthod. 1988; 10:283-295 https://doi.org/10.1093/ejo/10.4.283
Naoumova J, Kurol J, Kjellberg H. Extraction of the deciduous canine as an interceptive treatment in children with palatal displaced canines – part I: shall we extract the deciduous canine or not?. Eur J Orthod. 2015; 37:209-218 https://doi.org/10.1093/ejo/cju040
Fernández E, Bravo LA, Canteras M. Eruption of the permanent upper canine: a radiologic study. Am J Orthod Dentofacial Orthop. 1998; 113:414-420 https://doi.org/10.1016/s0889-5406(98)80013-9
Benson PE, Atwal A, Bazargani F Interventions for promoting the eruption of palatally displaced permanent canine teeth, without the need for surgical exposure, in children aged 9 to 14 years. Cochrane Database Syst Rev. 2021; 12:(12) https://doi.org/10.1002/14651858.CD012851.pub2
Naoumova J, Kürol J, Kjellberg H. Extraction of the deciduous canine as an interceptive treatment in children with palatally displaced canines – part II: possible predictors of success and cut-off points for a spontaneous eruption. Eur J Orthod. 2015; 37:219-229 https://doi.org/10.1093/ejo/cju102
Cobourne M. Chapter 8: Early management of the palatally displaced maxillary permanent canine. Orthodontic Management of the Developing Dentition. 2017; 131-149
Parkin N, Benson PE. Current ideas on the management of palatally displaced canines. Faculty Dent J. 2011; 2:24-29
Grisar K, Chaabouni D, Romero LPG Autogenous transalveolar transplantation of maxillary canines: a systematic review and meta-analysis. Eur J Orthod. 2018; 40:608-616 https://doi.org/10.1093/ejo/cjy026
Becker A, Chaushu S. Success rate and duration of orthodontic treatment for adult patients with palatally impacted maxillary canines. Am J Orthod Dentofacial Orthop. 2003; 124:509-514 https://doi.org/10.1016/s0889-5406(03)00578-x
Alawsi F, Sawbridge D, Fitzgerald R. Orthodontics in patients with significant medical co-morbidities. J Orthod. 2020; 47:(1_suppl)4-24 https://doi.org/10.1177/1465312520949881
Armstrong C, Johnston C, Burden D, Stevenson M. Localizing ectopic maxillary canines – horizontal or vertical parallax?. Eur J Orthod. 2003; 25:585-589 https://doi.org/10.1093/ejo/25.6.585
Coupland MA. Localisation of misplaced maxillary canines: orthopantomograph and P.A. skull views compared. Br J Orthod. 1984; 11:27-32 https://doi.org/10.1179/bjo.11.1.27
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Management of the Palatally Displaced Maxillary Canine. Part 1: Extract, Align or Avoid?

From Volume 15, Issue 3, July 2022 | Pages 125-130

Authors

Tom Frawley

BDS(Hons), MFDS, MClinDent, MOrth RCS Edin

Post-CCST in Orthodontics, Sheffield and Barnsley

Articles by Tom Frawley

Nicola Parkin

BDS, FDS RCS, MMedSci, MOrth, FDSOrth

Consultant Orthodontist, Charles Clifford Dental Hospital, Sheffield, UK

Articles by Nicola Parkin

Abstract

The decision-making process in the management of a patient with a palatally displaced canine can be complex, with several clinical and patient-related variables, each requiring careful consideration, both individually and in unison. In this article, we discuss these factors, along with the available treatment options and their underlying evidence base.

CPD/Clinical Relevance: Alignment of palatally displaced maxillary canine represents a common and potentially challenging clinical task for all orthodontists. A detailed understanding of the factors that can potentially influence the success of this approach should help clinicians to reach an appropriate treatment decision for each individual patient as part of a risk–benefit approach.

Article

Maxillary canine ectopia is a relatively common problem, affecting approximately 1–3% of those of European origin.1 Although palatally displaced maxillary canines (PDCs) were previously thought to account for around 85% of such malpositions, studies using CBCTs have demonstrated that this is closer to 60%.2

The aetiology of the PDC is multifactorial in nature, occurring due to an interaction between an individual's genetic coding and various environmental factors, such as an absent or diminutive lateral incisor. While the relative importance of the genetic and guidance theories remains the subject of debate,3,4 the familial tendency, higher female prevalence and association with other dental anomalies all suggest that the genetic component may be of greater importance (Figure 1).

The Royal College of Surgeons of England (RCS Eng) guidelines on PDCs broadly categorize management into five treatment options5. Unfortunately, the evidence base underpinning several of these options is fairly weak.

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