Extraction of a horizontally impacted mandibular canine through a genioplasty approach: report of a case

Evaluation of dental age and associated developmental anomalies in subjects with impacted mandibular canines

OBJECTIVES

To assess the null hypothesis that there is no difference in the rate of dental development and the occurrence of selected developmental anomalies related to shape, number, structure, and position of teeth between subjects with impacted mandibular canines and those with normally erupted canines.

MATERIALS AND METHODS

Pretreatment records of 42 subjects diagnosed with mandibular canines impaction (impaction group: IG) were compared with those of 84 subjects serving as a control reference sample (control group: CG). Independent t-tests were used to compare mean dental ages between the groups. Intergroup differences in distribution of subjects based on the rate of dental development and occurrence of selected dental anomalies were assessed using χ(2) tests. Odds of late, normal, and early developers and various categories of developmental anomalies between the IG and the CG were evaluated in terms of odds ratios.

RESULTS

Mean dental age for the IG was lower than that for the CG in general. Specifically, this was true for girls (P < .05). Differences in the distribution of the subjects based on the rate of dental development and occurrence of positional anomalies also reached statistical significance (P < .05). The IG showed a higher frequency of late developers and positional anomalies compared with controls (odds ratios 3.00 and 2.82, respectively; P < .05).

CONCLUSIONS

The null hypothesis was rejected. We identified close association of female subjects in the IG with retarded dental development compared with the female orthodontic patients. Increased frequency of positional developmental anomalies was also remarkable in the IG.

Correction of bilateral impacted mandibular canines with a lip bumper for anchorage reinforcement

Multiple treatment options are available to patients with impacted manibular canines in addition to a retained deciduous canine. This article describes the treatment of a prepubertal girl, aged 10 years 6 months, with a skeletal Class I, dental Class II Division 1 malocclusion, retrognathic mandible, deep overbite, proclined maxillary incisors, midline diastema, and bilateral mandibular canine impaction. The orthodontic treatment plan included extraction of the deciduous canine and forced eruption of the impacted canines. A modified lip bumper appliance was used both for forced eruption and to reinforce anchorage. Through the collaborative efforts of an orthodontist and an oral surgeon, an excellent esthetic and functional outcome was achieved.

Investigation of transmigrated and impacted maxillary and mandibular canine teeth in an orthodontic patient population

PURPOSE

The objectives of the present study were to determine the frequency and gender difference of transmigrated and impacted canines and to evaluate the characteristics and treatment protocols in a Turkish orthodontic patient population.

MATERIALS AND METHODS

We designed a retrospective study composed of pretreatment and post-treatment dental casts, intraoral photographs, and full mouth periapical and panoramic radiographs of 2,215 patients (1,275 females and 940 males). Observations were made regarding impacted mandibular and maxillary canines, retained deciduous canines, patient gender and age, side and number of transmigrated canines and associated pathologic features, and treatment of the impacted canines and transmigrated canines. The Pearson chi(2) test and Fisher's exact test were used to determine the potential differences in the distribution of canine impaction and transmigration when stratified by gender.

RESULTS

The frequency of patients with impacted and transmigrated canines was 5.1% and 0.3%, respectively. None of the patients with a transmigrated mandibular canine had any pathologic changes; however, the maxillary transmigrated canine was associated with impacted mesiodens. All transmigrated canines were unilateral and impacted. Four canines migrated from the left to right, and 2 migrated from right to left. Of 6 patients, 2 had retained primary canines and 4 had exfoliated primary canines. Three of the transmigrated mandibular canines were type 1 and 2 were type 2. In the treatment protocol, 4 impacted mandibular canines and 78 maxillary canines were surgically exposed for orthodontic treatment, 4 of 6 transmigrated canines were surgically removed, and 2 were observed periodically.

CONCLUSIONS

If the diagnosis of canine impaction and transmigration in patients is made earlier, it is possible that the tooth might have been in a better position for orthodontic eruption into the arch. Careful patient selection and preparation are therefore essential, as is cooperation between the orthodontist and oral surgeon.

Transmigrant Mandibular Canines

PURPOSE

The aim of the present study was to investigate the patterns of transmigrant mandibular canines, the incidence and classification of transmigrant canines, and the associated pathology of these teeth.

PATIENTS AND METHODS

This retrospective cohort study was composed of 4,500 panoramic radiographs of patients who presented to our Oral and Maxillofacial Surgery Services from January 1998 to December 2005. Panoramic radiographs were reviewed. Observations were made on the status of missing permanent mandibular canines, retained deciduous canines, side and number of transmigrant canines, gender and age of patients, and any other associated pathology.

RESULTS

In the present study, a total of 15 patients had transmigrated canines-6 females (ages 13-33 years) and 9 males (ages 13-57 years). All transmigrant canines were unilateral. Two canines were impacted in the mandible enveloped in cystic lesions. The rest of the transmigrated canines were in varying stages of intraosseous travel and positioning within the mandible, with no pathological entity.

CONCLUSION

The use of a panoramic radiograph is imperative and is recommended for discovering such rare malpositions. If the mandibular canine that has migrated across the mandible is associated with pathology, it may be removed. Otherwise, it should be kept under observation.