Impacted Canine

Background: Permanent canines are amongst the teeth most affected by impaction and ectopic eruption. Although impacted canines are often subjected to surgical exposure and alignment with either the open or the closed technique for many decades, their treatment effects have not yet been systematically asssessed. Objectives: The aim of this systematic review was to critically assess whether significant differences exist in the outcomes of the open or closed surgical exposure of impacted canines. Search methods: An unrestricted electronic search of nine databases from inception to December 2016 was performed. Selection criteria methods: Included were randomized or prospective non-randomized studies comparing open versus closed exposure of impacted canines in human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and odds ratios (ORs), including their 95 per cent confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of eight unique studies and a total of 433 (30.1% male/59.9% female) patients were included, with an average age of 15.2 years and a total of 453 impacted canines (48.6% and 51.4% in the open and closed exposure, respectively). Open exposure of impacted canines was associated with reduced duration of canine alignment (two studies; MD = –2.14 months; 95% CI = –4.23 to –0.05 months; P < 0.05; moderate heterogeneity and moderate quality) and lower odds of tooth ankylosis (one study; OR = 0.15; 95% CI = 0.03–0.83; P < 0.05; low quality) compared to closed exposure; both findings being independent of canine localization. However, initial alignment of palatally impacted canines took overall significantly longer than labially impacted canines (8.87 versus 4.17 months). Conclusions: Based on existing evidence, open surgical exposure seems to be superior in treatment duration and ankylosis risk over the closed technique. Due to the limited number of small included trials, further research is needed for robust clinical recommendations. Registration: PROSPERO (CRD42016051916).

When the upper canines are impacted, the
adjacent lateral incisors are at increased risk of
root resorption, depending on the relationship between
the incisor and canine roots. Therefore, the
incisors should not serve as anchorage for erupting
the canines, as is the case with most previously
described techniques. Furthermore, when mechanics
such as the Kilroy Spring are used, we have
clinically observed that the lateral incisors require
additional palatal root torque at the end of the
eruption process.
We have designed a new spring for eruption
of impacted canines, the Shoulder Spring, that
does not require patient compliance and does not
use the lateral incisors for anchorage.

Aim: Dental impaction is a very frequent problem and the canine tooth is one of the most affected. Impacted canines result
in many complications and their early diagnosis by radiographic evaluation is imperative. The aim of the present study was
to determine the prevalence of impacted canines in the population of western part of India. Materials and Methods: The
panoramic radiographic records of 4133 patients attending the Department of Oral Medicine and Radiology, between
September 2008 and December 2012 were examined for the study. The age of the patients ranged from 15 to 67 years,
with a mean of 26.7 years. Results: The prevalence of canine impaction in males was 2.3% and 3.6% in females. The
overall prevalence was 2.9%. Maxillary left canines were the most frequently impacted (89.3%). Only 13 cases showed
impaction of the mandibular canine. Unilateral impaction was seen in 94% of the patients. Conclusion: Canines play a vital
role in facial appearance, dental esthetics, arch development, and functional occlusion. If signs of ectopic eruption are
detected early, every effort should be made to prevent impaction and its consequences. Early intervention eliminates the
need for surgical intervention and complex treatment.

Introduction: When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, extraction is the only option available, followed by implant placement; this is a challenge due to the bone resorption frequently associated with complex tooth extraction that often necessitates bone grafting. Immediate dental implant placement appears to be the adequate strategy to replace missing teeth.
Objective: The aim of this systematic review was the evaluation of implant placement immediately after removal of maxillary canine impacted.
Methods: Detailed search in PubMed and Cochrane databases to obtain information on all reported cases and postoperative outcomes. There were no restrictions with regard to publication status or language of publication.
Selection criteria: Only included all clinical reports of at least 1-year follow up and that treated by immediate implant in maxillary canine impacted extraction.
Results: The initial database search produced 135 titles, after careful examination only 11 reports considered to be met the criteria for inclusion. The remaining reports were to be no met the criteria for inclusion. The results indicated a success rate significant for the procedure of immediate implant placement into impacted maxillary canine extraction socket accompanied by guided bone regeneration (GBR). This procedure allowing implant anchorage and primary stability to achieved.
Conclusion: Our review suggest that this treatment is viable and with a good outcome, although more works is needed to determine adequate the results and thus determine the potential impact of this treatment alternative.