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Clinical audit: the importance of early detection and referral of impacted maxillary canines Oluwatoyin Aiyegbusi Sukbir Nandra Dental Update 2024 46:5, 707-709.
Authors
OluwatoyinAiyegbusi
BDS, MFDS RCSGlas
Oral Maxillofacial Surgery, Restorative and Special Care Dentistry at Royal Preston Hospital
A retrospective clinical audit was conducted to analyse referrals for impacted maxillary canines received by the Orthodontic Department of Queen Elizabeth Hospital, Kings Lynn. The primary aim of the audit was to determine if patients with impacted maxillary canines were referred at the appropriate age of 12 or under, as required by the Royal College of Surgeons of England guidelines and, secondly, to determine if appropriate radiographs were taken in patients aged 10 and over, as recommended by British Orthodontic Society Radiography guidelines. The results indicate that there is a significant shortfall in meeting the 100% standards set for both clinical guidelines.
CPD/Clinical Relevance: This article highlights the importance of timely referral of suspected impacted maxillary canines and explores the potential consequences to both patient and practitioner of failing to refer patients by the appropriate age.
Article
Permanent maxillary canines begin development high in the maxilla at age 4 to 5 months and crown formation is complete by age 6.1 The canines should be palpable in the buccal sulcus by age 10. At age 11 to 12, it is expected that the maxillary canines should have erupted into their final position; this generally occurs earlier in females than males.2
If a maxillary canine is impacted, there will be failure of its eruption into the maxillary arch. Maxillary canines are the second most commonly impacted teeth after lower third molars, and this affects up to 2% of the general population, with a 2:1 male to female ratio.2 Impacted maxillary canines are often associated with other dental anomalies, such as peg-shaped lateral incisors.3 The cause of canine impaction is obscure, but is commonly attributed to polygenic multifactorial inheritance as there are gender, familial and population variances in its prevalence.4, 5
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