Orthodontics > Ectopic Canines > Flashcards

Ectopic Canines Flashcards

(42 cards)

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0
Q

What are the problems with canines?

A

Ectopic

Transposed

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1
Q

Why are canines important?

A
  • Corner stones of dental arch
  • Long rooted teeth so good long term prognosis for perio
  • Difficult replace prosthetically
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2
Q

What percentage of maxillary canines are ectopic?

A

2-3%

85% Palatal
15% buccal

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3
Q

What percentage of ectopic canines are associated with root resorption of the laterals?

A

12% more common with Palatal

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4
Q

How does the canine migrate during eruption?

A

It migrates down and forward distal to the root of the lateral incisor

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5
Q

At what age shoud canines be palpable in the buccal sulcus?

A

9/10

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6
Q

What age do canines erupt?

A

12

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7
Q

What are the causes for ectopic canines?

A
  • Retained C
  • Displacement of dental crypt
  • missing laterals/diminutive lateral
  • Crowding (especially buccally)
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8
Q

Why are missing or diminutive laterals associated with ectopic canines?

A

Less guidance

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9
Q

What do you need to examine when investigating canines?

A

Presence
Position
Pathology

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10
Q

What are the clinical signs of possibly ectopic canines?

Reference

A

brin et al 1986

  • Not palpable in buccal sulcus by aged 10
  • C’s not mobile
  • Asymmetric loss of C’s
  • peg shaped laterals
  • Missing laterals
  • labially inclined laterals which suggests buccal,impactin
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11
Q

What can you use as an adjunct to clinical examination to determine presence and location of 3’s?

A

Radiograph

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12
Q

What must you look for on the radiographically examination?

A
  1. C’s root resorbing?
  2. Any signs of pathology eg resorbing roots of laterals or centrals
  3. Determine position
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13
Q

What radiographically technique is used to determine the position of the 3’s?

A

Parallax

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14
Q

What is the principle to parallax?

A

Relative movement of the canine in relation to other adjacent teeth when two radiographs are taken with an angle between them

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15
Q

what rule do we use to determine the position of the tooth when using parallax?

A

SLOB
Same Lingual
Opposite Bucaal

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16
Q

What radiographic views can you use in horizontal parallax?

Study These Flashcards
A

Ant occlusal and Periapical
2 pas
DPT and pa

17
Q

What views can you use in vertical parallax?

Study These Flashcards
A

DPT and ant occlusal

18
Q

What interceptive techniques are there for impacted canines ? Ref

Study These Flashcards
A

Ericsson and kurol 1988
1. Extraction of C’s
At age 10-13
Suggested 78% will improve of there is no crowding (power and short 1993)

19
Q

When is interception indicated and more successful?

Study These Flashcards
A
  1. Young patent ~10
  2. Space available
  3. 3 only overlaps lateral but not central
20
Q

When is active treatment indicated ?

Study These Flashcards
A
  1. Pt aged 13
  2. Crowded case
  3. If canine does not improve significantly 6 mths post extraction
21
Q

What are the treatment options following ectopic canines?

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A
  1. leave alone and review
  2. Expose and align
    3.extarct plus or minus ortho
    4 create space and replace
    5.transplant
22
Q

What are the factors to consider when deciding which treatment?

Study These Flashcards
A
  • Position of canine
  • Crowding
  • Age of pt
  • Cooperation
  • Condition of root of C
  • Appearnce of lateral
  • Other pathology
23
Q

What circumstances would you leave the ectopic canine and review?

Study These Flashcards
A

Canine in hopeless position
Pt not interested in treatment
Increased risks from surgery to pt
C has good root morph

MUST make sure review radiographically

24
What three things do you need to consider when assessing the position of the canine for ortho?
1. Height 2. mesio-distal position 3. Angulation
25
Discuss the issues of canine height with regards to ortho prognosis ?
The crown tip of the canine is at or above the apical third of the incisor roots: POOR PROG
26
Discuss the issues of canine mesio distal position with regards to ortho prognosis ?
Canine is more than half way across the upper incisor : POOR PROG
27
Discuss the issues of canine angulation with regards to ortho prognosis ?
Smaller than angle with the occlusal place (the more horizontal) POOR PROGNOSIS
28
When is expose and alignment a good option?
Age: longer treatment period in older patient s Co-operation: 2+yrs of treatment OH MH: since surgical treatment
29
T/F | Expose and Alignment is usually a treatment option of choice ?
T | In well motivated patients and canine in an okay position and enough space or can make space
30
What is important when there is buccal inaction?
Avoid pulling through non keratinised mucosa so need to 1. bond bracket and gold chain or 2. use an apically repositioned flap
31
How do you perform the expose and aligning?
Expose crown and leave to erupt for 8 weeks then apply traction Buccal - closed exposure Palatal - open exposure
32
When would you chose to extract plus or minus ortho?
In v crowded cases where 4/2 makes good contact Poor prognosis for alignment and risk of lateral resorption Patient not interested in ortho but leaving canine is a risk
33
What are the restorative treatment options?
Bridge: not ideal due to canine guidance on Pontic Implant: not in growing patient
34
When would transplants be indicated?
Rarely Poor long term prognosis and operator sensitive Better prognosis if root is only 2/3 formed Need ortho anyway to create space Possibility of tooth ankylosis in growing pt
35
Which tooth are maxillary canines most commonly transposed with?
First premolar | Sometimes lateral
36
Which tooth are mandibular canines most commonly transposed with?
Lateral
37
What do you do in cases where the canine is transposed ?
Do not try to move the canine back Accept and align with FA Rotate 4 medically to hide Palatal root
38
What percentage of mandib canines are ectopic?
0.3%
39
Which gender have ectopic Maxilliary canines more?
Females
40
What are palatally impacted canines mainly caused by?
Polygenic | Multifacotrial
41
What is buccal canine impaction mainly causes by?
Crowding
Orthodontics
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