Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 24
Impacted Maxillary Canines: Survey Responses
Oregon Health and
Science University
University of
Washington
University of Alberta
University of British Columbia
Approximately how many cases
with impacted canines does each
resident treat?
5
3
2 to 3
2, but more depending on who
shows up with impacted teeth
When potential impaction of a
maxillary canine is recognized in
the mixed dentition, what course
of action is recommended?
Extraction of primary canines, distalization,
observation
Extraction of primary canines,
expansion
Extraction of primary canines, Expansion,
observation
Extraction of primary canines,
extraction of primary canines
and first molars, expansion, distalization, extraction of permanent canines
For each course of action you
recommended in Question #2,
outline the indications or patient
characteristics that would lead
you to choose that approach.
Extraction of primary canines if crown of erupting
canine is overlapping root of lateral incisor in pano;
distalization if space for canine is inadequate;
observation if overlap with lateral incisor root is
minimal and space is adequate
Extraction of primary canines
if Class I; expansion if crowding,
constricted maxilla, posterior
crossbites
Extraction of primary canines when crown
tip of potentially impacted canine is medial
to a vertical line splitting the upper lateral in
two; expansion if there is an apparent transverse deficiency; observation- most of the
cases will require monitoring before decisions are made
Permanent canine in zone 1-4;
for severe ectopic eruption in
crowded cases, extraction of permanent canines may be recommended
To whom is the patient referred
Periodontist for gingivectomy, apically repositioned
for each of the following maxillary flap and tunnel technique; periodontist or oral surgeon for open and closed exposures; oral surgeon
canine exposure techniques?
for transalveolar transplantation
Periodontist for gingivectomy, api- Resident or periodontist for gingivectomy;
cally repositioned flap, open and
oral surgeon for all other procedures
closed exposures, tunnel technique;
oral surgeon for apicotomy and
transalveolar transplantation
Periodontist or resident for open
and closed exposures
Approximately how many of each
of the following techniques does
a resident encounter?
10 gingivectomy, 2 apically repositioned flap, 4 open
and closed exposures, 1 tunnel technique
3 gingivectomy, 1 open exposure, 2
closed exposures, 1 transalveolar
transplantation
1 to 2 open and 1 closed exposure
1 open and 1 closed exposure
Are residents required to be present at exposure appointments?
No
No
No
No, but encouraged
Which diagnostic tests are routinely used to identify and locate
impacted canines?
Periapicals, CBCT
Periapicals, panoramic, CBCT
Panoramic, CBCT
Periapicals, panoramic, ceph,
CBCT
How is the severity of the
impaction determined?
Angle of impaction and position of canine crown
Angle of impaction and position of
canine crown
Angle of impaction
Angle of impaction and position
of canine crown
Is a CBCT image taken on all
patients with canine impactions?
If not, what is the criteria for
choosing to take a CBCT?
No; CBCT used if localizing the impacted tooth is
challenging using 2-D radiographic assessment;
varies with instructor as well
No; only if canine position is
unclear
Most likely; some instructors still feel comDepends on case, instructor, and
fortable making decisions with conventional supervising perio staff
radiography but the OS will certainly take a
SFV CBCT
What techniques are routinely
used for traction of a maxillary
canine displaced palatally?
Ballista loop, elastic thread, C-chain, piggyback NiTi
archwires
Elastic thread, Ballista spring
Modified TPA with cantilever arm, engagement to auxiliary continuous wire
What techniques are routinely
used for traction of a maxillary
canine displaced labially?
Create space and let erupt on its own; deflected
piggyback archwire; elastic thread
Elastic thread
Cantilever spring or direct traction with aux- Elastic thread and chain
iliary AW based on canine height
How soon after surgery is orthodontic traction initiated?
Typically within 1 to 2 weeks
Within days
Depends on patient's age; older than 9 will
As soon as possible
likely get traction started as soon after surgical recovery
If mild root resorption is detected
on the maxillary lateral incisor,
what is the next step? How does
this change if the root resorption
is severe?
Try to move impacted canine away from lateral inci- Lateral incisor not engaged in fixed
sor root; if severe damage, consider option of canine appliances
substitution
Ballista spring, TPA
Analysis of need for extractions based on
discrepancy; if mild, inform patient and proceed with treatment, while monitoring RR;
the more severe, the more extraction of the
lateral is considered, either for space closure
or to keep space for future implant/crown
Monitor; if severe, rest for 3
months
What is the protocol for ankylosed Have tooth extracted; consider backup plan for
either tooth substitution or prosthetic replacement
canines?
Leave in place
Likely extraction or leaving it where it is
Extract or decoronate
What is the retention protocol
after correction of an impacted
maxillary canine? Does retention
design vary based on severity /
location of impaction? If so, how?
Removable retainers, and sometimes lingually bonded wire
Nothing specific; individual case analysis
Bonded lingual-spring to lingual
of Hawley; bonded resin on
labial to prevent intrusion with
modified labial bow
24
No particular special retention protocol
PCSO Bulletin Summer 2017
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Summer 2017
No label
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - No label
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 2
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 3
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 4
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 5
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 6
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 7
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 8
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 9
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 10
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 11
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 12
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 13
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 14
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 15
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 16
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 17
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 18
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 19
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 20
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 21
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 22
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 23
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 24
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 25
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 26
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 27
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 28
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 29
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 30
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 31
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 32
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 33
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 34
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 35
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 36
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 37
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 38
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 39
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 40
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 41
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 42
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 43
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 44
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 45
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 46
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 47
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 48
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 49
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 50
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 51
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 52
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 53
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 54
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 55
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 56
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 57
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 58
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 59
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 60
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 61
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 62
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 63
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 64
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 65
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 66
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 67
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 68
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 69
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 70
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 71
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 72
Pacific Coast Society of Orthodontists Bulletin Summer 2017 - 73
https://www.nxtbook.com/allen/pcso/bulletin_summer2023
https://www.nxtbook.com/allen/pcso/95-2
https://www.nxtbook.com/allen/pcso/95-1
https://www.nxtbook.com/allen/pcso/94-4
http://www.brightcopy.net/allen/pcso/94-03
http://www.brightcopy.net/allen/pcso/94-02
http://www.brightcopy.net/allen/pcso/93-3
http://www.brightcopy.net/allen/pcso/93-2
http://www.brightcopy.net/allen/pcso/93-1
http://www.brightcopy.net/allen/pcso/92-3
http://www.brightcopy.net/allen/pcso/92-2
http://www.brightcopy.net/allen/pcso/92-1
http://www.brightcopy.net/allen/pcso/91-4
http://www.brightcopy.net/allen/pcso/91-3
http://www.brightcopy.net/allen/pcso/91-2
http://www.brightcopy.net/allen/pcso/91-1
http://www.brightcopy.net/allen/pcso/90-04
http://www.brightcopy.net/allen/pcso/90-3
http://www.brightcopy.net/allen/pcso/90-2
http://www.brightcopy.net/allen/pcso/90-1
http://www.brightcopy.net/allen/pcso/83-4
http://www.brightcopy.net/allen/pcso/89-3
http://www.brightcopy.net/allen/pcso/89-2
http://www.brightcopy.net/allen/pcso/89-1
http://www.brightcopy.net/allen/pcso/88-4
http://www.brightcopy.net/allen/pcso/88-3
http://www.brightcopy.net/allen/pcso/88-2
http://www.brightcopy.net/allen/pcso/88-1
http://www.brightcopy.net/allen/pcso/87-4
https://www.nxtbook.com/allen/pcso/87-03
https://www.nxtbook.com/allen/pcso/87-2
https://www.nxtbook.com/allen/pcso/87-1
https://www.nxtbook.com/allen/pcso/86-4
https://www.nxtbook.com/allen/pcso/86-3
https://www.nxtbook.com/allen/pcso/86-2
https://www.nxtbook.com/allen/pcso/86-1
https://www.nxtbook.com/allen/pcso/85-4
https://www.nxtbook.com/allen/pcso/85-3
https://www.nxtbook.com/allen/pcso/85-2
https://www.nxtbook.com/allen/pcso/85-1
https://www.nxtbook.com/allen/pcso/preview-program-2013
https://www.nxtbook.com/allen/pcso/84-4
https://www.nxtbook.com/allen/pcso/84-2
https://www.nxtbookmedia.com