Extraction of an Impacted Canine

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Maxillary canines are the most commonly impacted teeth, second only to third molars. Maxillary canine impaction occurs in approximately 2% of the population and is twice as common in females as it is in males.
The genetic theory points to genetic factors as a primary origin of palatally displaced maxillary canines and includes other possibly associated dental anomalies.
It has been suggested that the following clinical signs might be indicative of canine impaction:
1. Delayed eruption of the permanent canine or prolonged retention of the deciduous canine beyond 14–15 years of age,
2. Absence of a normal labial canine bulge,
3. Presence of a palatal bulge, and
4. Delayed eruption, distal tipping, or migration (splaying) of the lateral incisor.
When to Extract an Impacted Canine
1. If it is ankylosed and cannot be transplanted,
2. If it is undergoing external or internal root resorption,
3. If its root is severely dilacerated,
4. If the impaction is severe (e.g., the canine is lodged between the roots of the central and lateral incisors and orthodontic movement will jeopardize these teeth),
5. If the occlusion is acceptable, with the first premolar in the position of the canine and with an otherwise functional occlusion with well-aligned teeth,
6. If there are pathologic changes (e.g., cystic formation, infection), and
7. If the patient does not desire orthodontic treatment.