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This orthodontic case report highlights the unpredictable behaviour of ectopic maxillary permanent canines. An 11-year-old male patient had bilateral ectopic maxillary canine teeth that were in high positions and initially left in situ and monitored. During orthodontic treatment, there was rapid spontaneous eruption of both teeth with resulting resorption to an adjacent lateral incisor. This case report details the clinical findings and progress of treatment and management. A review of the literature reinforces the importance of maintaining regular radiographic review to assess for migration of ectopic teeth, and to ensure appropriate treatment planning and assessment of potential complications.
CPD/Clinical Relevance: This report highlights the need for regular radiographic review of impacted canines in younger patients.
Article
Maxillary impacted canines have a high developmental position and long path of eruption, with canine impaction and non-eruption being a common problem. The incidence of impacted canines is well reported in the literature at between 1% and 3% of the population.1,2 Impaction is more common in females, with a ratio of 7:3, with 8% of cases being reported as bilateral impactions.3,4 The majority of the literature states that impacted canines are most commonly found to be palatally positioned, with reports varying between 41% and 85%.1 The presence of a lateral incisor seems to be important for eruption guidance of the canine, with a higher incidence of canine impaction when the lateral incisor is absent or diminuitive.5 Canine impaction is also more common with Class 2 division 2 malocclusions.3,6 It is important to establish the location of impacted maxillary canines as part of the orthodontic assessment and treatment planning process, as well as the presence of any associated pathology. The position of the impacted canine will determine the prognosis for, and complexity of, alignment.5
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