Skip to main content
SpringerLink
Log in

Early Management of the Palatally Displaced Maxillary Permanent Canine

  • Chapter
  • First Online:
Orthodontic Management of the Developing Dentition

Abstract

This chapter describes the current evidence concerning the early management of the palatally displaced canine (PDC).

To practice effective interceptive treatment, normal development must be understood. Key papers are summarized, which help in the diagnosis of a PDC, and some thought is given to the timing of interceptive treatment. Any intervention should be undertaken early enough to allow time for self-correction, and it appears the optimum time is when a child is aged 10–13 years.

Justification for extracting the primary canine often stems from one, extensively cited, study that had no control group. The study methodology was not robust, and it is possible that many of the canines included might have erupted without intervention. Little knowledge is gained from this investigation; however, it has evoked much interest, and many studies have been published subsequently exploring the same concept. These will be described, as well as alternative interceptive techniques, such as space creation, using maxillary expansion devices, headgear and/or fixed appliances.

We conclude that most published trials in this field have inadequate detail or inconsistencies in reporting, dictating the need for further well-designed clinical trials. After studying the available literature, it appears that the horizontal sector is the best predictor for outcome, with success defined as eruption of the permanent canine without the need for surgical uncovering. We have developed guidelines to help the practitioner decide when interceptive treatment might be appropriate. These guidelines are based on conventional radiography as, currently, this is most commonly used in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Berkovitz BKB, Holland GR, Moxham BJ. Oral anatomy, histology and embryology. 4th ed. Edinburgh: Mosby Elsevier; 2009.

    Google Scholar 

  2. Coulter J, Richardson A. Normal eruption of the maxillary canine quantified in three dimensions. Eur J Orthod. 1997;19(2):171–83.

    Article  PubMed  Google Scholar 

  3. Ericson S, Kurol J. Longitudinal study and analysis of clinical supervision of maxillary canine eruption. Community Dent Oral Epidemiol. 1986a;14(3):172–6.

    Article  PubMed  Google Scholar 

  4. Ericson S, Kurol J. Radiographic examination of ectopically erupting maxillary canines. Am J Orthod Dentofac Orthop. 1987;91(6):483–92.

    Article  Google Scholar 

  5. Thilander B, Myrberg N. The prevalence of malocclusion in Swedish schoolchildren. Scand J Dent Res. 1973;81(1):12–21.

    PubMed  Google Scholar 

  6. McSherry P, Richardson A. Ectopic eruption of the maxillary canine quantified in three dimensions on cephalometric radiographs between the ages of 5 and 15 years. Eur J Orthod. 1999;21(1):41–8.

    Article  PubMed  Google Scholar 

  7. Becker A, Chaushu S. Etiology of maxillary canine impaction: a review. Am J Orthod Dentofac Orthop. 2015;148(4):557–67. doi:10.1016/j.ajodo.2015.06.013.

    Article  Google Scholar 

  8. Rutledge MS, Hartsfield JK. Genetic factors in the etiology of palatally displaced canines. Semin Orthod. 2010;16(3):165–71.

    Article  Google Scholar 

  9. Chaushu S, Kaczor-Urbanowicz K, Zadurska M, Becker A. Predisposing factors for severe incisor root resorption associated with impacted maxillary canines. Am J Orthod Dentofac Orthop. 2015;147(1):52–60. doi:10.1016/j.ajodo.2014.09.012.

    Article  Google Scholar 

  10. Shetty R, Sandler PJ. Keeping your eye on the ball. Dent Update. 2004;31(7):398–402.

    Article  PubMed  Google Scholar 

  11. Ericson S, Kurol J. Radiographic assessment of maxillary canine eruption in children with clinical signs of eruption disturbance. Eur J Orthod. 1986b;8(3):133–40.

    Article  PubMed  Google Scholar 

  12. Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. Eur J Orthod. 1988;10(4):283–95.

    Article  PubMed  Google Scholar 

  13. Lindauer SJ, Rubenstein LK, Hang WM, Andersen WC, Isaacson RJ. Canine impaction identified early with panoramic radiographs. J Am Dent Assoc. 1992;123(3):91–2. 95–97

    Article  PubMed  Google Scholar 

  14. Warford JH Jr, Grandhi RK, Tira DE. Prediction of maxillary canine impaction using sectors and angular measurement. Am J Orthod Dentofac Orthop. 2003;124(6):651–5. doi:10.1016/S0889540603006218.

    Article  Google Scholar 

  15. Fernandez E, Bravo LA, Canteras M. Eruption of the permanent upper canine: a radiologic study. Am J Orthod Dentofac Orthop. 1998;113(4):414–20.

    Google Scholar 

  16. Sambataro S, Baccetti T, Franchi L, Antonini F. Early predictive variables for upper canine impaction as derived from posteroanterior cephalograms. Angle Orthod. 2005;75(1):28–34. doi:10.1043/0003-3219(2005)075<0028:EPVFUC>2.0.CO;2.

    PubMed  Google Scholar 

  17. Sajnani AK, King NM. Early prediction of maxillary canine impaction from panoramic radiographs. Am J Orthod Dentofac Orthop. 2012;142(1):45–51. doi:10.1016/j.ajodo.2012.02.021.

    Article  Google Scholar 

  18. Peck S (2011) Problematic sample in the study of interception of palatally displaced canines. Am J Orthod Dentofac Orthop. 140(1):2–3; author reply 3–4. doi:10.1016/j.ajodo.2011.05.004

  19. Bazargani F, Magnuson A, Dolati A, Lennartsson B. Palatally displaced maxillary canines: factors influencing duration and cost of treatment. Eur J Orthod. 2013;35(3):310–6. doi:10.1093/ejo/cjr143.

    Article  PubMed  Google Scholar 

  20. Iramaneerat S, Cunningham SJ, Horrocks EN. The effect of two alternative methods of canine exposure upon subsequent duration of orthodontic treatment. Int J Paediatr Dent. 1998;8(2):123–9.

    Article  PubMed  Google Scholar 

  21. Parkin N, Furness S, Shah A, Thind B, Marshman Z, Glenroy G, Dyer F, Benson PE (2012) Extraction of primary (baby) teeth for unerupted palatally displaced permanent canine teeth in children. Cochrane Database Syst Rev 12:CD004621. doi:10.1002/14651858.CD004621.pub3

  22. Buchner HJ. Root resorption caused by ectopic eruption of maxillary cuspid. Int J Orthod. 1936;22:1236–7.

    Article  Google Scholar 

  23. Power SM, Short MB. An investigation into the response of palatally displaced canines to the removal of deciduous canines and an assessment of factors contributing to favourable eruption. Br J Orthod. 1993;20(3):215–23.

    Article  PubMed  Google Scholar 

  24. Leonardi M, Armi P, Franchi L, Baccetti T. Two interceptive approaches to palatally displaced canines: a prospective longitudinal study. Angle Orthod. 2004;74(5):581–6. doi:10.1043/0003-3219(2004)074<0581:TIATPD>2.0.CO;2.

    PubMed  Google Scholar 

  25. Naoumova J, Kurol J, Kjellberg H. A systematic review of the interceptive treatment of palatally displaced maxillary canines. Eur J Orthod. 2011;33(2):143–9. doi:10.1093/ejo/cjq045.

    Article  PubMed  Google Scholar 

  26. Baccetti T, Leonardi M, Armi P. A randomized clinical study of two interceptive approaches to palatally displaced canines. Eur J Orthod. 2008;30:381–5.

    Article  PubMed  Google Scholar 

  27. Bonetti GA, Parenti SI, Zanarini M, Marini I. Double vs single primary teeth extraction approach as prevention of permanent maxillary canines ectopic eruption. Pediatr Dent. 2010;32(5):407–12.

    Google Scholar 

  28. Bonetti GA, Zanarini M, Parenti SI, Marini I, Gatto MR. Preventive treatment of ectopically erupting maxillary permanent canines by extraction of deciduous canines and first molars: a randomized clinical trial. Am J Orthod Dentofac Orthop. 2011;139(3):316–23. doi:10.1016/j.ajodo.2009.03.051.

    Article  Google Scholar 

  29. Koletsi D, Pandis N, Polychronopoulou A, Eliades T. Does published orthodontic research account for clustering effects during statistical data analysis? Eur J Orthod. 2012;34(3):287–92. doi:10.1093/ejo/cjr122.

    Article  PubMed  Google Scholar 

  30. Bazargani F, Magnuson A, Lennartsson B. Effect of interceptive extraction of deciduous canine on palatally displaced maxillary canine: a prospective randomized controlled study. Angle Orthod. 2014;84(1):3–10. doi:10.2319/031013-205.1.

    Article  PubMed  Google Scholar 

  31. Naoumova J, Kurol J, Kjellberg H. Extraction of the deciduous canine as an interceptive treatment in children with palatal displaced canines - part I: shall we extract the deciduous canine or not? Eur J Orthod. 2015a;37(2):209–18. doi:10.1093/ejo/cju040.

  32. Naoumova J, Kurol J, Kjellberg H. Extraction of the deciduous canine as an interceptive treatment in children with palatally displaced canines-part II: possible predictors of success and cut-off points for a spontaneous eruption. Eur J Orthod. 2015b;37(2):219–29. doi:10.1093/ejo/cju102.

    Article  PubMed  Google Scholar 

  33. Baccetti T, Mucedero M, Leonardi M, Cozza P. Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofac Orthop. 2009;136(5):657–61. doi:10.1016/j.ajodo.2008.03.019.

    Article  Google Scholar 

  34. Baccetti T, Sigler LM, McNamara JA Jr. An RCT on treatment of palatally displaced canines with RME and/or a transpalatal arch. Eur J Orthod. 2011;33(6):601–7. doi:10.1093/ejo/cjq139.

    Article  PubMed  Google Scholar 

  35. Sigler LM, Baccetti T, McNamara JA Jr. Effect of rapid maxillary expansion and transpalatal arch treatment associated with deciduous canine extraction on the eruption of palatally displaced canines: A 2-center prospective study. Am J Orthod Dentofac Orthop. 2011;139(3):e235–44. doi:10.1016/j.ajodo.2009.07.015.

    Article  Google Scholar 

  36. Silvola AS, Arvonen P, Julku J, Lahdesmaki R, Kantomaa T, Pirttiniemi P. Early headgear effects on the eruption pattern of the maxillary canines. Angle Orthod. 2009;79(3):540–5. doi:10.2319/021108-83.1.

    Article  PubMed  Google Scholar 

  37. Armi P, Cozza P, Baccetti T. Effect of RME and headgear treatment on the eruption of palatally displaced canines: a randomized clinical study. Angle Orthod. 2011;81(3):370–4. doi:10.2319/062210-339.1.

    Article  PubMed  Google Scholar 

  38. Olive RJ. Orthodontic treatment of palatally impacted maxillary canines. Aust Orthod J. 2002;18(2):64–70.

    PubMed  Google Scholar 

  39. Olive RJ. Factors influencing the non-surgical eruption of palatally impacted canines. Aust Orthod J. 2005;21(2):95–101.

    PubMed  Google Scholar 

  40. Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Br Med J. 2010;340:c869.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Sheffield, Sheffield, UK

    Philip E. Benson & Nicola A. Parkin

Authors
  1. Philip E. Benson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicola A. Parkin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philip E. Benson .

Editor information

Editors and Affiliations

  1. Department of Orthodontics Centre for Craniofacial Development and Regeneration, King’s College London Dental Institute, London, United Kingdom

    Martyn T. Cobourne

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Benson, P.E., Parkin, N.A. (2017). Early Management of the Palatally Displaced Maxillary Permanent Canine. In: Cobourne, M. (eds) Orthodontic Management of the Developing Dentition. Springer, Cham. https://doi.org/10.1007/978-3-319-54637-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54637-7_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54635-3

  • Online ISBN: 978-3-319-54637-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation