Success rates of different management techniques for impacted mandibular canines and associated complications in children and adolescents

Comparisons of Dental Anomalies in Orthodontic Patients with Impacted Maxillary and Mandibular Canines

To assess the presence and possible associations between the type of dental anomalies and maxillary and mandibular canine impactions in orthodontic patients treated for canine impaction, panoramic radiographs of orthodontic patients treated for canine impaction were assessed for the presence of associated dental anomalies. A random sample of orthodontic patients without canine impaction matched for age and gender served as controls. Descriptive and exact inferential statistics were implemented in order to assess potential associations between canine impaction and dental anomalies. A total of 102 orthodontic patients with 70 maxillary (MaxCI) and 32 mandibular (ManCI) canine impactions were assessed. The control group included 117 orthodontic patients. Dental anomalies were present in more than 50% of patients with impacted canines and in 20% of the controls. Tooth agenesis was significantly more common in the MaxCI group when compared to the ManCI group, while supernumerary teeth and canine transmigration were registered more often in the ManCI group. When compared to the control group, peg-shaped maxillary lateral incisors and tooth agenesis were significantly more prevalent in the MaxCI group, while canine transmigration, supernumerary teeth, the agenesis of mandibular incisors and tooth transpositions were significantly more prevalent in the ManCI group. The impaction of other teeth was significantly more common in both canine impaction groups when compared to the controls. The prevalence of dental anomalies in orthodontic patients with impacted canines was higher than in orthodontic patients without canine impaction. Different types of tooth anomalies were found in the MaxCI and ManCI groups.

Pulp revascularization after autotransplantation of the mandibular canines with partially resected roots. Report of five cases with follow-ups between 26 and 80 months

INTRODUCTION

Transmigrated (migrated through the midline) mandibular canines constitute a treatment challenge. Advanced transmigration can be successfully treated by autotransplantation. In developing canines, pulp revascularisation is typical after transplantation. On the contrary, the pulp of teeth with completed apex formation does not undergo revascularization. In this case, root canal treatment becomes compulsory and decreases the success of autotransplantation. The aim of this observational retrospective study was to evaluate whether partial resection of the root (performed during the autotransplantation of mature canines) would enable revascularization of the pulp after the surgery.

METHODS

Five transmigrated mandibular canines with complete apex formation before the surgery were evaluated. During the autotransplantation surgery, the resection of 2-4 mm of the root apex was performed to open the path for revascularisation of the pulp after surgery. The transplanted teeth were observed during healing after the surgery for the presence of pulp obliteration. Clinical and radiographic examinations were performed.

RESULTS

All treated canines survived the minimum observation period of two years (ranging from 26 to 80 months, mean: 55 months) without pulp healing complications. The survival was 100 percent, and the success was 80 percent. In one canine, the external cervical root resorption was diagnosed and treated one year after the surgery. At the final examination, transplanted canines presented radiographic features of pulp obliteration, normal mobility, and healthy periodontal tissues.

CONCLUSIONS

The surgical protocol proved to be successful in promoting revascularization to maintain pulp vitality, in all cases. The outcomes confirm that autotransplantation, combined with the resection of the root, constitutes as a valid treatment for mature ectopic canines.

Comparisons of different treatment methods and their outcomes for impacted maxillary and mandibular canines: A retrospective study

BACKGROUND

Impacted canines may pose a functional and an esthetic problem for patients and can affect neighboring incisors. The aim of the study was to compare different treatment methods and their outcomes for impacted maxillary and mandibular canines.

METHODS

The authors included 102 patients with 118 impacted canines (82 maxillary and 36 mandibular canines). Impacted canine were confirmed during clinical and radiologic examinations. Eighty-five patients (83%) with 97 impacted canines started the treatment. The authors analyzed treatment types and outcomes. Two maxillary and 4 mandibular canines were scheduled for extraction.

RESULTS

Orthodontic extrusion was used most frequently to treat impacted maxillary canines (89%), whereas orthodontic extrusion and transalveolar transplantation were performed most frequently in impacted mandibular canines (33% and 37.5%, respectively). The treatment was successful in 96% of the maxillary and 95% of the impacted mandibular canines.

CONCLUSIONS

Different methods were used for impacted maxillary and mandibular canines, but their overall success rate was high.

PRACTICAL IMPLICATIONS

Successful outcome is determined via a well-planned and carefully executed orthodontic and surgical treatment. Early diagnosis is pivotal in facilitating spontaneous canine eruption and implementing transalveolar transplantation in a timely way.