Palatal canine impaction is associated with craniofacial shape in humans.

BACKGROUND/OBJECTIVES: It is unclear whether palatal canine impaction is related to genetic or local/environmental factors. If a genetic origin is assumed, then it could be expected that palatal canine impaction is associated with overall craniofacial development. Within this context, the aim of this study was to evaluate the craniofacial morphology of individuals with palatal canine impaction and compare it to a matched group of normal controls. MATERIALS/METHODS: The sample for this investigation comprised 404 individuals (232 females and 172 males). Half of these individuals presented with unilateral or bilateral palatal canine impaction confirmed clinically and radiographically. The other half were matched for sex and age with the first half and comprised individuals without tooth impaction, apart from third molars. The shape of the craniofacial structures was outlined on calibrated cephalometric images through 15 curves and 127 landmarks (11 fixed and 116 semi-landmarks). Shape configurations were superimposed using Procrustes Superimposition and the resulting shape coordinates were reduced into principal components for all subsequent analyses. The effect of palatal canine impaction on craniofacial shape was assessed with regression models, separately in females and males. All statistical tests were performed assuming a type-1 error of 5%. RESULTS: Individuals with palatally impacted canines appear to have a less convex face, a more brachyfacial skeletal pattern, and a sagittally extended premaxilla. In females effect sizes ranged between η2 = 0.136-0.397 (P < 0.05) and in males between η2 = 0.125-0.396 (P < 0.05, apart from the entire craniofacial configuration: P = 0.259). LIMITATIONS: Palatal canine impaction was not confirmed through cone beam computer tomography images in all patients, however, in those cases, the treatment history confirmed the diagnosis. CONCLUSIONS/IMPLICATIONS: Palatal canine impaction is related to a distinct craniofacial shape in females and males. These findings allow for speculation that palatal canine impaction is affected by genetic pathways involved in overall craniofacial development.

Surgical-orthodontic approach of two palatally impacted canines with maxillary lateral incisor anomalies in a growing class II patient: A case report.

INTRODUCTION: After the mandibular third molars, the maxillary canines are the most displaced or impacted teeth in permanent dentition. Surgical-orthodontic disimpaction of impacted canines, followed by aesthetic reconstructions, can be a successful treatment choice. AIM: The aim of this case report was to describe the smile restoration through simultaneous surgical disimpaction of the two upper permanent canines in a 13-year-old patient who also presented with agenesis of the right upper lateral incisor and a conoid-shaped left upper lateral incisor. TREATMENT PROTOCOL: The present case report followed the Care Checklist For Case Reports. After having completed the multibrackets fixed orthodontic therapy phase necessary for the preparation of the anchorage, avulsions of the upper deciduous canines were carried out, followed by the making of surgical full thickness palatal flap in order to perform traction of the permanent canines, and an orthodontic eyelet with passive metal looped ligatures was applied. One week after the surgery, traction was started with Crescini-double arch technique. Subsequently, the avulsion of elements 2.2 and 5.2 were executed. At the end of orthodontic treatment, in order to optimise the aesthetics and function of the canines, a restorative treatment was carried out. RESULTS AND CONCLUSIONS: After the surgical creation of a palatal flap, the disimpaction of the two upper canines, using the double arch technique, allowed the teeth to be moved into the desired position on the upper arch.

Prevalence of impacted and transmigrated canines in orthodontic patients - A radiographic study.

Background: The canine plays a vital role in dentofacial aesthetics and function. It supports the base of the alar and upper lip, which are crucial for smile aesthetics. When impacted, these functions are lost, leading to low self-esteem and overall poor health-related quality of life. The present study was conducted to find the prevalence of impacted and transmigrated canines in orthodontic patients and also to find the most prevalent type of canine impaction. Materials and Methods: This retrospective study was conducted in a hospital setting at Dental College. A total of 3050 OPGs (Orthopantomagram) of patients who visited dental hospitals for orthodontic treatment constituted the final sample. Demographic details regarding age, gender, and place of residence were collected from the patients. Evaluation of sample radiographs on the standard light box was performed to collect data regarding impacted and transmigrated canines. Statistical analysis was performed using descriptive statistics and Chi-square test. Results: Prevalence of impacted canine was found to be 2.46%. Impacted canine prevalence of 1.53% and 2.85% was reported in males and females, respectively. Only two female patients had transmigrated mandibular impacted canines. Comparison of arch showed a statistically significant (P value 0.02) higher prevalence in the maxillary arch, which was 1.54%, and in the mandibular arch, it was 0.92%. The present study reported significantly more unilateral impactions (P value 0.00) than bilateral impactions. Conclusion: The overall prevalence for impacted canine was 2.46%. Prevalence was higher in female patients. Early diagnosis of impacted canines is vital for planning orthodontic treatment in such patients.

Morphological evaluation of maxillary arch in unilateral buccally and palatally impacted canines: a cone-beam computed tomography (CBCT)-based study in Northern Iran.

Purpose: This study investigated the association between the maxillary impacted canines' position and the maxilla's morphological features in an Iranian population based on cone-beam computed tomography (CBCT) images. Material and methods: In this cross-sectional descriptive-analytical study, 47 CBCT images of unilateral buccally impacted maxillary canines and 47 CBCT images of unilateral palatally impacted maxillary canines were examined. Several morphological variables were compared between the impacted and non-impacted sides, and between the buccal and palatal impaction types. Results: Gender and age were not significantly associated with the canine impaction type. The alveolar bone height at the impacted side was significantly greater in the buccally impacted group than in the palatally impacted group (p = 0.016). In a comparison of the impacted and non-impacted sides, all variables of alveolar bone thickness at depth of 2 mm, maxillary arch width, and palatal volume had significantly smaller values in the impacted side in both buccally and palatally impacted groups (p < 0.05). The alveolar bone was significantly thicker at the depth of 10 mm in the impacted side of the buccal group (p = 0.024). The maxillary arch perimeter was significantly smaller in the impacted side of the buccal group (p = 0.008). The palatal depth did not significantly differ between the groups. Conclusion: Among the studied variables, the alveolar bone thickness showed contrary results at different depths. The palatal volume and maxillary arch width were significantly smaller on the impacted side in both buccal and palatal groups, and the arch perimeter showed the same results only in the buccal group.

Effect of Aligning Forces by Two Preadjusted Edgewise Techniques on a Buccally Positioned Maxillary Canine at Varying Vertical Displacements: A Finite Element Study.

Objective: To evaluate the effect of continuous arch and piggyback mechanics in a straight wire appliance (SWA) for the alignment of buccal and variably vertically positioned maxillary canines. Methods: A three-dimensional finite element model with near-normal occlusion and buccal and vertically displaced maxillary canines was used. Two groups were created to simulate two commonly used SWAs techniques, continuous archwire (Group 1) and piggyback models (Group 2). Each group had three subgroups with varying vertical displacement of the canine from 2 to 6 mm from the occlusal plane. The displacement and stress distribution were noted in each group. Results: As the vertical displacement increased in Group 1, the concentration of von Mises stress increased progressively at the incisal third (0.36, 0.41 and 0.44 MPa) at 2, 4, and 6 mm, respectively, with decreased maximum occlusal movement in the vertical plane with respect to the canine. Group 2 exhibited a similar pattern but greater occlusal movement of the canine compared with Group 1. Conclusion: A vertical displacement of 4 mm is the optimal level at which continuous arch mechanics should be considered. For displacements beyond 4 mm, the piggyback wire technique is a suitable alternative.

The Effect of Maxilla Impacted Canine Positions on Root Resorption of Adjacent Teeth Using Cone-Beam Computed Tomography Imaging.

Objective: To determine the effect of the impacted position of the maxillary canine on the root resorption of the adjacent incisor using Cone-beam Computed Tomography (CBCT) imaging. Methods: This was an analytic quantitative study. The research sample determined CBCT images of treatment patients at the Orthodontic Specialist Policlinic in Dental Hospital of Airlangga University over a three-year period and secondary data taken from Pramita Laboratory. CBCT photos that met the inclusion criteria, including mesially impacted canine or close to central or lateral incisors with completely formed anatomy were then analyzed. Multiple linear regression was used to determine x-axis, y-axis, z-axis position of the impacted canine on the severity of root resorption of the adjacent incisor, and the effect of impacted canines on all axes simultaneously on the severity of root resorption of the adjacent incisors. Results: The position of the impacted canine in the x-axis and z-axis planes had a significant influence on the root resorption of the adjacent incisor. Meanwhile, impacted canine from the y-axis plane showed non-significant influence on the root resorption. Conclusion: The position of the impacted canine when viewed in all planes of the tooth axis has a significant effect on the severity of root resorption of the adjacent incisor.

Prevalence of canine impaction in different cities of Saudi Arabia: A systematic review.

Background: To our knowledge, no systematic review assessed and gathered information about the prevalence of impacted canines among the Saudi population. The purpose of this study was to critically assess the previously published studies about the prevalence of canine impaction according to impaction type (buccal/ palatal), gender (male/female), and location (maxillary/mandibular, right/left), are among the Saudi population. Methods: PubMed (MEDLINE), Scopus, the Web of Science, Dimensions, and Semantic Scholar databases were searched systemically for articles related to the topic of the study published between 1987 and 2022. The PRISMA statements were used to conduct a systematic review with the help of the Best Practice for Survey and the Public Opinion Research scales by the American Association for Public Opinion Research (AAPOR) to assess and evaluate the selected studies' quality. Results: The initial search of the databases yielded 221 articles. After discarding duplicates, 161 were selected for further evaluation. Eventually, 16 articles were selected for inclusion in this study. Regarding the quality of the selected articles, all articles, except one, were of high quality. Only one was of medium quality. Conclusion: It was found that the incidence of palatal canine impactions was higher than buccal impactions. Females had a higher prevalence of canine impactions as compared to males. There were more canine impactions in the maxilla than the mandible and more on the left side than the right one.

The effect of the dental follicle volume of palatally impacted canines on the relative position of the adjacent teeth.

OBJECTIVE: To assess if the dental follicle volume of palatally impacted canines (PICs) affects the relative root position of the adjacent lateral incisors (LIs) and first premolars (FPs). MATERIALS AND METHODS: A retrospective cross-sectional study of 49 patients with unilaterally PICs with dental follicles who had CBCT imaging previously taken. Four orthodontic centers in different countries provided the sample. A mean difference of 5° between the angular measurements (mesiodistal tip, buccolingual inclination, or mesiodistal rotation) of the LI and FP adjacent to the PIC and the controls was considered clinically relevant. A value of 0.05 was set for significance level and a power of 80%. The minimum sample size was determined to be 26 patients. These patients were further assigned to an LI sample (n = 49) and an FP sample (n = 23), dependent on the direct contact of the dental follicle to that adjacent tooth. A manual segmentation technique was used to obtain the volumetric measurements of the dental follicle. Angular measurements of adjacent teeth were then compared to the contralateral nonimpacted side, which acted as the control. A multivariant regression analysis was performed using IBM SPSS software, and statistical significance was set at α = 0.05. RESULTS: Adequate intra-rater reliability was accomplished. The multivariant regression analysis implied that there is no difference in the mean change in the tip, torque, and rotation of the LI and FP between the impacted and control sides when dental follicle volumes are considered (P = .509 for the LI sample and P = .804 for the FP sample). LIMITATIONS: CBCT imaging of dental follicle border delimitations, partial volume effect, and scattering are limitations. This is a convenience sample where the FP subsample is small. CONCLUSION: The dental follicle volume of the PICs does not seem to influence the relative position of the adjacent LI and FP mesiodistal tip, buccolingual inclination, and mesiodistal rotation. Early intervention could have been suggested to avoid certain malocclusion traits if significant displacements were demonstrated.

The effect of maxilla impacted canine positions on root resorption of adjacent teeth using cone-beam computed tomography imaging

Objective@#To determine the effect of the impacted position of the maxillary canine on the root resorption of the adjacent incisor using Cone-beam Computed Tomography (CBCT) imaging. @*Methods@#This was an analytic quantitative study. The research sample determined CBCT images of treatment patients at the Orthodontic Specialist Policlinic in Dental Hospital of Airlangga University over a three-year period and secondary data taken from Pramita Laboratory. CBCT photos that met the inclusion criteria, including mesially impacted canine or close to central or lateral incisors with completely formed anatomy were then analyzed. Multiple linear regression was used to determine x-axis, y-axis, z-axis position of the impacted canine on the severity of root resorption of the adjacent incisor, and the effect of impacted canines on all axes simultaneously on the severity of root resorption of the adjacent incisors. @*Results@#The position of the impacted canine in the x-axis and z-axis planes had a significant influence on the root resorption of the adjacent incisor. Meanwhile, impacted canine from the y-axis plane showed non-significant influence on the root resorption. @*Conclusion@#The position of the impacted canine when viewed in all planes of the tooth axis has a significant effect on the severity of root resorption of the adjacent incisor

Computer-guided surgical exposure of palatally displaced canines: a technical note.

AIM: To present a minimally invasive approach to expose palatally displaced canines (PDCs) using a surgical guide. MATERIALS AND METHODS: Surgical guides for palatal canine exposure are fabricated with CAD/CAM technology. With adequate software, it is possible to match the STL files of the dental arch with the DICOM images of the maxilla. On the STL 3D model file, the operator can localize and determine the exact position of the impacted canine. In turn, this allows the identification of the ideal location of the window. A software application facilitates the design of the surgical guide, which is printed using a 3D printer. RESULTS: Exposure of PDCs can be achieved satisfactorily using surgical guides. CONCLUSIONS: The use of computer-guided surgical exposure of PDCs allows both the reduction of surgical time and surgical invasiveness, minimizing patients' postoperative discomfort. Controlled clinical trials are necessary to evaluate more fully any advantages of this minimally invasive technique.

Incidence of Canine Impaction in Tribal Population of Jharkhand.

Introduction: The position of the canine has a key role in facial harmony, dental aesthetics, functional occlusion, and health of temperomandibular joint. Maxillary canine impaction is the second most common tooth after third molars impaction. Maxillary canines are more prone to impaction due to longer path of eruption. Settings and Design: All the patients were examined in the Dental Chair light and referred to the department of Oral Radiology for Orthopantomogram. Yamamoto's classification was used to classify maxillary canine impaction. Position of mandibular canine from cement-enamel junction was used for mandibular canine impaction. Materials and Methods: The study was performed on 2300 patients who consulted the orthodontic department from January 2018 to July 2022. Orthopantomogram of each patient was examined for canine impaction, retained deciduous teeth, cyst, and other anomalies. The incidence and pattern of canine impaction was assessed. Statistical Analysis: The data was then statistically analyzed using Graph Pad Prism software. The incidence of impacted canine was evaluated. The effect of gender was evaluated using a t-test. Results: A total of 2300 subjects were examined out of which 52 individuals were diagnosed with canine impaction. The incidence of canine impaction among orthodontic patients is 2.26%. The amount of canine impaction in females (60%) is higher than males (40%). The ratio of canine impaction of the maxilla and mandible is 2.5. Conclusion: The incidence of canine impaction was found to be 2.26 percent in the tribal dominant population of Jharkhand. Type II (50%) pattern in the maxilla and Level A (57%) impaction in the mandible was found to be the highest.

Morphological types of sella turcica bridging and sella turcica dimensions in relation to palatal canine impaction: a retrospective study.

The aim of this study was to determine the relationship between the presence of sella turcica bridging and palatal canine impaction (PCI) using several classification methods. In this retrospective study, lateral cephalometric radiographs of 120 subjects with PCI (43 males, 77 females; mean age 18.8 ± 7.8 years) and 120 controls (44 males, 76 females; mean age 18.1 ± 5.6 years) with complete permanent dentition were examined. The extent of sella turcica bridging was assessed using two different methods, and the types of complete sella turcica bridging were evaluated. The sella turcica dimensions were measured and analyzed using the t-test, and comparison of the presence of sella turcica bridging was performed using the two-tailed Fisher's exact test. The frequency of complete sella turcica bridging was significantly higher in subjects with PCI (18.3%) than in controls (8.3%, p = 0.023) but without significant differences in the occurrence of sella turcica bridging of Type A (ribbon-like fusion) and Type B (extension of clinoid processes). No significant differences in partial bridging were found between patients with PCI and controls according to both methods. The length and the anteroposterior diameter were significantly larger in subjects with PCI and no difference was observed between the groups in the sella turcica depth. Complete sella turcica bridging occurred significantly more frequently in subjects with PCI than in controls. However, the association between partial bridging and PCI was not confirmed, therefore, we do not recommend any classification of partial bridging for clinical practice.

Normal pre-eruptive inclinations of maxillary canine, lateral incisor, and first premolar in children aged 6-14 years.

BACKGROUND: Maxillary canine is the second most common tooth that gets impacted after III molars. Early pre-eruptive inclination changes of first premolar and its associative changes with canine inclination are an important factor that predicts the fate of maxillary canines. Hence, a cross-sectional study was planned to evaluate the normal pre-eruptive mesiodistal inclinations of maxillary permanent canine, first premolar, and lateral incisor in children aged 6-14 years using orthopantomogram. MATERIALS AND METHODS: The total number of participants was 296. Each group of boys and girls consisted of 37 participants in each of the age groups 6-8 years, 8-10 years, 10-12 years, and 13-14 years, making up a total of 148 boys and 148 girls. Routine clinical examination was conducted, and orthopantomograph was taken for radiographic examination. Orthopantomographs of all these participants were collected. Inclination of lateral incisor, inclination of canine, and inclination of premolar with midline were measured on the orthopantomogram. Also, the angles between the canine with lateral incisor and canine with first premolar were measured. Pearson correlation was also evaluated between the movement of canine with lateral incisor and canine with first premolar. RESULTS: All the mean angles related to lateral incisor, canine, and first premolar with midline were recorded. Also, the angles between the canine with lateral incisor and the canine with first premolar were recorded. The movements between lateral incisor, canine, and first premolar were moderately correlated from 6 to 12 years of age. CONCLUSION: The eruption of canine from the floor of the nose till it erupts has its synchronized influence on the lateral incisor and the first premolar.

Unilateral vs Bilateral Maxillary Canine Impaction: A Cone-Beam Computed Tomography Study of Patterns and Associations.

AIM: This retrospective study aimed to compare and evaluate the pattern of maxillary canine impaction and its association with other anomalies using cone-beam computed tomography (CBCT). METHODS: A total of 59 CBCT records of patients (ages 12 and up) were divided into two groups: A total of 35 subjects with unilateral canine impactions and 24 subjects with bilateral canine impactions. The CBCT data were analyzed for the measurement of qualitative and quantitative variables. RESULTS: In unilateral canine impaction, the mesiodistal (MD) width of the central incisors and the nasal cavity (NC) width were wider (p < 0.05). The canine-palatal plane (U3-PP) distance was significantly longer in bilateral canine impaction (p < 0.05). The distance of the impacted canines from the palatal and mid-sagittal planes, the anterior dental arch width, and the maxillary skeletal width changed significantly with the position of the impacted canines (p < 0.05). Males had 0.185 odds of presenting with a bilateral canine impaction as compared to females (p = 0.025). The odds of having bilateral canine impaction with a longer canine-midsagittal plane (U3-MSP) distance was 1.30 (p = 0.003). CONCLUSION: The findings indicate a gender predilection with females showing a greater prevalence of bilateral canine impaction. Supernumerary teeth were associated with unilateral impacted canines and lower canine impaction with bilaterally impacted canines. CLINICAL SIGNIFICANCE: Anomalies in the form of the maxillary central and lateral incisors, distance from the maxillary canine to the palatal plane and the mid-sagittal plane, NC width, maxillary skeletal width, and gender, are the best discriminating parameters between unilateral and bilateral canine impactions.

Three-Dimensional Measurements of the Palate and Dental Arch Perimeter as Predictors for Maxillary Palatal Canine Impaction-A Cone-Beam Computed Tomography Image Analysis.

(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal dimensions, and maxillary arch perimeter using digital measurements and determine the factors that could be used as predictors for maxillary palatal canine impaction. (2) Method: A cross-sectional study was conducted on cone-beam computed tomography images of orthodontic patients aged 15 to 25. Palatal dimensions and maxillary arch perimeter were digitally measured using Materialize Interactive Medical Image Control System. (3) Results: A significant difference was found between the case and the study groups regarding palatal depth, length, and arch perimeter, except for the palatal width. A weak correlation was reported in palatal depth and length with canine impaction, whereas the correlation was moderate concerning the arch perimeter. They can be used as predictors for palatal canine impaction. (4) Conclusion: Palatal dimensions and dental arch perimeter affect maxillary palatal canine impaction. Deficient arch perimeter, palatal depth, and length could be helpful in the prediction of maxillary palatal canine impaction.

Association between maxillary canine impaction and other dental anomalies: radiological study of a mixed dentition children's cohort from an orthodontic clinic.

PURPOSE: To investigate the significance of association between maxillary impacted canines and various dental anomalies. METHODS: Files of 874 orthodontic patients were evaluated for the presence of maxillary impacted canines. From this sample, a group of 97 patients (39 males and 58 females) with at least 1 impacted maxillary canine consisted the study group. This group was compared to a control group of 97 patients (42 males and 55 females) that was created by random selection from the initial sample without maxillary canine impaction. The impaction diagnosis was made from the panoramic radiographs. Chi-square test was used to perform the analysis for significant associations. Stepwise discriminant analysis, binary logistic regression and classification tree were used to identify best combinations. RESULTS: Statistically significant difference was found for peg-shaped maxillary lateral incisors and infraoccluded deciduous molars. The presence of peg-shaped upper lateral incisors arises the probability of impacted canine to 83.3%, a distal displaced unerupted second premolar to 63.16% and the impaction of any other teeth to 80% as showed by the classification tree. CONCLUSIONS: The presence of peg-shaped maxillary lateral incisors and infraocclusion of deciduous molars can be considered major valuable early risk indicators for maxillary canine impaction, because they manifest before the maxillary canine eruption. Special consideration should be given on distal displaced unerupted second premolar and the impaction of any other teeth. Patients with these dental anomalies are candidates for future interceptive treatment for canine eruption.

Effects of Ballista and Kilroy Springs on Palatally Impacted Canines: A Finite Element Model Analysis.

Objective: This study evaluated the stress distribution and displacement on impacted maxillary canines and their adjacent teeth of orthodontic forced eruption using Ballista and Kilroy springs by finite element model (FEM) analysis. Methods: Two different FEMs applying the same force level on an impacted canine tooth (Model 1: Ballista spring, Model 2: Kilroy spring) were conducted using FEM analysis and the principal stresses, von Mises stresses, and displacements were evaluated. Results: Von Mises values at the cusp tip of impacted canines were measured as 0.009896 N/mm² in the Ballista model and 0.015334 N/mm² in the Kilroy model. The highest value was measured in the buccal apex of the first premolar in both spring designs. The extrusion was observed in Ballista, and intrusion was observed in the Kilroy model at the apex of the first premolar. The Ballista model showed the highest value (0.003642 N/mm²) at the buccal tip of the first premolar, while in the Kilroy model, the highest measurement (0.002989 N/mm²) was shown at the incisal edge of the lateral tooth. Conclusion: Von Mises stress values were higher in the Kilroy model at the cusp tip and apical part of the impacted tooth than that in the Ballista model. The highest von Mises stress values were concentrated on the buccal root apex of the first premolar in both models. Although the amount of force applied by the springs was the same, the stress values were different depending on the spring design.

Associations among the occurrence or types of maxillary canine impaction, labial frenum attachment types, lateral incisor anomalies, and midline diastema in patients with and without impaction: A case-control study.

INTRODUCTION: We tested whether the labial frenum attachment types may affect the occurrence or type of maxillary canine impaction. METHODS: This case-control study was performed on 96 subjects (48 with maxillary canine impaction [20.50±4.99 years, 32 females], 48 controls [21.94±3.79, 31 females]). Types of canine impaction (buccal/palatal, bilateral/unilateral, left/right), types of upper lip middle frenums (mucosal, gingival, papillary), the anatomy of lateral incisors (impacted, peg shaped, small, normal), and the midline diastema were evaluated clinically and radiographically. Associations were examined using multiple binary logistic regression, 3-way repeated-measures ANCOVA, and Fisher tests (α=0.05, ß=0.2). RESULTS: The numbers of mucosal, gingival, and papillary frenums in the case group were '29, 14, and 5', respectively; in the control group, they were '25, 21, and 2' (Fisher, P=0.248). The numbers of mucosal, gingival, and papillary frenums were respectively '25, 11, and 1' in the palatally impacted canine subgroup; they were '4, 3, and 4' in the buccally impacted subgroup (Fisher, P=0.010). Abnormal laterals were present in 12 cases and 4 controls; normal laterals were observed in 36 cases and 44 controls (Fisher, P=0.053). Abnormal laterals were seen in 10 cases with palatally impacted canines and 2 cases with buccally impacted canines; normal laterals existed in 27 cases with palatally impacted canines and 9 cases with buccally impacted canines (Fisher, P=0.705). Lateral anatomy was not associated with frenum attachment (Fisher, P=0.827). Greater midline diastemas were seen in cases with maxillary canine impaction, papillary frenums, and abnormal laterals (ANCOVA, P≤0.016). CONCLUSIONS: Buccal type of canine impaction is positively associated with papillary labial frenums. Canine impaction is 3.6 folds more prevalent in cases with lateral abnormality. Midline diastema is positively and independently associated with canine impaction, papillary frenums, and abnormal laterals.

Long term outcomes of en-block autotransplantation of a tooth.

Repositioning of impacted teeth in the dental arch through en-bloc autotransplantation showed short-term efficacy of 89%. The objective of this study was to evaluate the technique for long-term efficacy. The analysis involved 23 teeth transplanted to the alveolar ridge through harvesting the tooth with the adjacent bone tissue. Development of the root was completed and the apical foramen was closed in all the teeth. The teeth were examined clinically and radiologically (CBCT) and compared to contralateral ones. The obtained data were analysed statistically. The efficacy of the procedure amounted to 81% including two teeth lost at an early stage and another two lost during follow-up. The mean age of patients upon performing the procedure was 29.8. The long-term follow-up amounted to the mean of 34.3 months. In the study group recession of 1-2 mm as well as 3-5 mm was found, which was not noted on the control group. In 11.1% of the study group teeth the external root resorption was observed. No transplanted tooth underwent root canal treatment, no periapical changes were observed at CBCT and 77.8% of those showed positive reaction to ethyl chloride. One case of ankylosis was observed in tooth 11 and in two cases increased mobility of the transplanted tooth was found. Regeneration of nerves as well as revascularization in the en-bloc autotransplantation proceeded with high predictability and the risk of ankylosis of the treated tooth seemed to be negligible. Gingival recession was observed more often in case of en-bloc transplantation compared to the control group. The long-term follow-up suggested that this the technique does not prevent external resorption in 100%.

Investigation of the relationship between maxillary dimensions and labial and palatal maxillary impacted canines using cone beam computed tomography.

OBJECTIVES: To compare the maxillary dimensions of individuals with labial and palatal bilateral maxillary canine impaction and a control group of individuals with no impaction using CBCT. METHODS: 45 patients were included in the study with age range of 13 to 18 and consisted of 22 females and 23 males. The sample included three groups of 15 patients as the control, labial and palatal group. The measurements made on the axial and coronal planes were made on the levels of the 1st premolar and the 1st molar. Also nasal cavity and anteroposterior depth were measured. RESULTS: The maxillary anteroposterior depth, basal first molar width, alveolar first molar and premolar width and first molar palatal vault depth of the control group were significantly higher than labial and palatal groups (p<0.05).The basal first premolar width of the control group was significantly higher than palatal group (p<0.05). The first premolar palatal vault depth and nasal cavity width of the palatal group were significantly lower than other groups (p<0.05). CONCLUSIONS: The basal and alveolar widths associated with the molars and the palatal depths were lower in the impacted group than control group. The anatomical structures in the female patients were affected by the position of impaction to a higher extent in comparison to the anatomical structures in the male patients.