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The aberrant canine part 1: aetiology and diagnosis

From Volume 10, Issue 4, October 2017 | Pages 126-130

Authors

Tarun K Mittal

BDS

Specialty Registrar, Derriford Hospital, Plymouth

Articles by Tarun K Mittal

Nikki E Atack

BDS, MSc, MOrth RCS, FDS RCS

Consultant Orthodontist, Musgrove Park Hospital, Taunton and School of Oral and Dental Sciences, University of Bristol

Articles by Nikki E Atack

Hywel J Naish

BSc, BDS, MFDS RCS(Ed), MOrth RCS(Ed)

Specialist Practitioner, Cathedral Orthodontics, Cardiff, CF11 9LN

Articles by Hywel J Naish

Julie C Williams

BDS, MFGDP, DPDS MA (Ethics of Healthcare)

StR in Orthodontics, Musgrove Park Hospital, Taunton and Yeovil District Hospital and University of Bristol, Bristol, UK

Articles by Julie C Williams

James S Puryer

BDS, DPDS, MFDS RCS(Eng), MSc, FHEA

Clinical Teaching Fellow in Restorative Dentistry, School of Oral and Dental Sciences

Articles by James S Puryer

Jonathan R Sandy

PhD, MSc, BDS, FDS MOrth, FMedSci

Professor in Orthodontics, Department of Child Dental Health, Bristol Dental Hospital, Bristol

Articles by Jonathan R Sandy

Abstract

Abstract: The eruption of the permanent canine, particularly the maxillary tooth, is a milestone in dental development. Although often uneventful, occasionally there are disturbances in eruption, the management of which can be one of the more challenging aspects of orthodontics. This article is presented in two parts. Part 1 gives an overview of the possible aetiology and diagnosis of the aberrant canine tooth.

CPD/Clinical Relevance: Awareness of the possible sequelae of unerupted canines is important in diagnosis and treatment planning.

Article

The permanent canine usually erupts uneventfully, but occasionally it may fail to do so. When this occurs there is a potential for the adjacent teeth to be damaged. Even when it does not cause any damage, treatment of the ectopically positioned canine can present a substantial challenge to the orthodontist. This paper presents a summary of the development and eruption of the permanent canine, both upper and lower, possible adverse effects of an aberrant position and the different treatment options.

Calcification of the upper and lower permanent canine teeth begins at 4 to 5 months post-partum, with crown formation being complete by the age of 5 years. The lower permanent canine erupts at around 10 years of age (± 6 months) and the upper canine at about 11.5 years (± 6 months). Although the upper permanent canine has a long path of eruption, the crown should be palpable beneath the mucosa in the buccal sulcus by the age of 10 years. Eruption is guided by the distal surface of the lateral incisor root in the case of the maxillary canine, and this can lead to the distal angulation of the lateral incisor. As a result, it is normal to see physiological spacing of the upper incisors in the mixed dentition (Figure 1), often referred to as the ‘ugly duckling’ stage, which then closes as the upper canines erupt, guided by the distal surfaces of the upper lateral incisor roots. Once the canines have fully erupted, the intercanine width in both the upper and lower arches is at its greatest and will then only reduce over time.1

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