Severe cases of ectopically erupting maxillary canine with excessive mesial angulation

Abstract

The aim of the present study was to examine retrospectively how best to treat severe cases of ectopically erupting maxillary canines with mesial angulation exceeding 50 degrees. From the ectopically erupting canines diagnosed at the Pediatric Dental Clinic of Niigata University Hospital, we selected for our study 14 severe cases in which mesial angulation exceeded 50 degrees. Nine ectopically erupting canines could be aligned within the arch after traction, and two canines are in the course of treatment, while three canines were removed. In the removed canines, the vertical length from the occlusal line of the crown top was shorter than that in the aligned canines with similar initial condition. This means that the vertical length to the occlusal line of the impacted canine influences the treatment complexity. In four similar ectopically erupting canines in which mesial inclination was nearly 80 degrees or greater and vertical length was over 30 millimeters with Sector 1 or 2 positioning distal to the midline of the root of its adjacent lateral incisor, the initial disruptive conditions were improved after extraction of the predecessor and/or fenestration of the affected canine. It is concluded that traction should be postponed until a few months after extraction of the predecessor if the ectopically erupting canine is located far away from the occlusal line (over 30 millimeters) and its mesial inclination is more than nearly 80 degrees; also that this treatment plan should be limited to cases in which the crown top belongs to Sector 1 and 2.