Evaluation of mandibular indices and cephalometric parameters in adolescents with impacted maxillary canines

Objectives: Maxillary impacted canines have an important place in orthodontics for the reason of being a common anomaly and its treatment is time consuming and difficult. The aim of this study was to investigate the mandibular indexes and cephalometric parameters in adolescents with impacted maxillary canines. Materials and Methods: The radiographs of 4026 patients aged 12–19 years old were scanned and a total of 155 patients were included in the study. Subjects were divided into three groups according to the permanent maxillary canines: Bilateral impacted canine (BIC) (52 subjects; mean age 15.02 ± 1.74 years), unilaterally impacted canine (UIC) (51 subjects; mean age 14.89 ± 1.39 years), and the control (52 subjects; mean age 14.84 ± 1.65 years) groups. Skeletal, soft tissue and dental measurements were performed on cephalometric radiographs. Mandibular index analyzes including the panoramic mandibular index (PMI), mental index (MI), antegonial index (AI), and gonial index (GI) measurements and also angular measurements of impacted maxillary canines were performed on panoramic radiographs. Data were analyzed statistically and P < 0.05 was considered significant. Results: Maxillary skeletal and dental measurements showed retrusive positioned maxillary dental arch in the sagittal direction in the impacted canine groups (P < 0.05). PMI and MI values were greater in the BIC and UIC groups than in control group (P < 0.05). There was no statistically significant difference in AI value among groups (P < 0.05). GI value of BIC group was found statistically lower than other groups (P < 0.05). Conclusion: Individuals with impacted maxillary canines have more retrusive maxillary dental arch and soft-tissue components. Furthermore, mandibular cortex was thicker in subjects with impacted maxillary canine than individuals with not and clinicians should keep in mind this when examine the panoramic radiographs in terms of early diagnosis of impacted maxillary canine teeth.

Decision-Making Criteria of Odontectomy or Surgical Exposure in Impacted Maxillary Canine Based on Treatment Difficulty Index Modification

Objective Canine impaction is a difficult condition to treat, and it usually necessitates a combination of surgical exposure and orthodontic traction or surgical extraction. An accurate assessment of the maxillary canine's position can help determine the severity of the impaction, the difficulty of therapy, and the treatment's prognosis. Materials and Methods A total of 55 impacted canines were studied and selected retrospectively. Difficulty indexes were used to measure the severity of impaction with pretreatment panoramic radiographs. Statistical Analysis Pearson correlation was used to test the validity of the difficulty index modification score. Regression statistical analysis was used to evaluate any correlation between total scoring from each index with surgical treatment. Results The validity test on the variable modification index score showed a valid value (p = 0.000). According to both treatment difficulty and modification index, odontectomy group showed higher mean of total scoring than surgical exposure group. Treatment difficulty and modification index showed a significant correlation with surgical treatment (p = 0.003 and p = 0.001). Conclusions The higher the severity of canine impaction, the greater is the possibility of odontectomy than surgical exposure. Both indexes can consider to be used in determining surgical treatment planning.

Canalis sinuosus approximation on an impacted maxillary canine: a case report

Objectives: This case report is aimed to report the finding of canalis sinuosus on an impacted maxillary canine using cone beam computed tomography (CBCT) examination. Case Report: A 21-year-old male was referred from orthodontic department to radiology department UNPAD Dental Hospital for CBCT to determine the treatment of malalignment asymptomatic maxillary canine. The case revealed the presence of canalis that was identified as a canalis sinuosus, a branch of the anterior superior alveolar nerve that rarely known by a practitioner, at the apex of impacted right maxillary canine. Conclusion: The information of this anatomical variation is important for professionals due to damage that may be caused during treatment. The use of advanced imaging examination is recommended to acknowledge the individual anatomical variation before determining the proper treatment planning.

Root Resorption of Adjacent Teeth Associated with Maxillary Canine Impaction in the Saudi Arabian Population: A Cross-Sectional Cone-Beam Computed Tomography Study

This study aimed to identify the location of root resorption in relation to an impacted maxillary canine and grade its severity using cone-beam computed tomography (CBCT) in the Saudi Arabian population. Materials and Methods: CBCT scans of 169 patients with maxillary canine impaction were evaluated. The location and the severity of root resorption of the affected tooth in relation to the impacted maxillary canine were recorded for each patient. Results: a total 204 impacted maxillary canines caused root resorption in 218 adjacent teeth. Maximum root resorption was present in 63.3% of the apical one-third of the root and 37.6% of the palatal surfaces. There was mild root resorption in 55%, moderate in 10% and severe in 35%. There was no statistically significant difference between the gender, age, type of impaction, side of impaction, and the number, location, or degree of root resorption. Multiple logistic regression models showed significant association (p = 0.024) between gender, type of impaction, and root resorption. A significant correlation was found between the level and the surface of the root resorption (p = 0.018). Conclusion: In the Saudi population, apical one-third root levels and palatal surfaces were primarily involved in root resorption caused by impacted canines. The females with bilateral canine impaction were more likely affected by root resorption.

Various methods of canine retraction in premolar extraction space: A case series

Following article is the review and presentation of various methodologies of canine retraction [e.g.– methods under sliding and friction less mechanics, facilitation with TADs (Temporary Anchorage Devices) and MOPs (Micro-Osteo-Perforations), and invasive procedures etc.] and comparison of these methods in terms of rate of canine retraction, and molar anchorage loss. Patient’s age ranges between 15y to 19y and only right maxillary canine was taken for comparison purpose.

Assessments of Prevalence of Ponticulus Posticus, Atlas Posterior Arch Deficiency, Sella Turcica Bridging, Maxillary Canine Impaction, and Associations Among Them in 500 CBCTs of Italian Orthodontic Patients

Background: The ponticulus posticus (PP) is an important anomaly of the atlas (C1 vertebra) with a complete or partial bone bridge that transforms the groove of the vertebral artery (VA) into a canal (arcuate foramen). The aim was to retrospectively determine prevalence of PP evaluating morphological features and the possible association with other dentoskeletal anomalies in the midface and neck area such as maxillary canine impaction (MCI), atlas posterior arch deficiency (APAD), and sella turcica bridging (SB).Methods: This study was conducted in the Department of Medical, Oral and Biotechnological Sciences of the University “G. D'Annunzio” in Chieti. The detection of PP was performed on 500 patients with cone beam CT (CBCT) images (6 to 87 years).Results: Analysis revealed the presence of uni- and bi-lateral PP in 110 patients (22%): 24 (4.8%) patients with bilateral complete PP, 12 (2.4%) patients with complete PP on the left, 6 (1.2%) patients with complete PP on the right, 8 (1.6%) patients with complete PP on the right and partial PP on the left, 6 (1.2%) patients with complete PP on the left and partial PP on the right, 26 (5.2%) patients with partial bilateral PP, 18 (3.6%) patients with partial left PP, and 10 (2%) patients with partial PP on the right. The Chi-squared statistic confirmed that there are significant associations between MCI and PP (p = 0.020) and between SB and MCI (p &lt;0.00001). No correlation between chronological age and presence of the PP (p = 0.982), between chronological age and morphotypes of the PP (p = 0.779), between APAD and the PP (p = 0.0757), between SB and the PP (p = 0.111), and between APAD and MCI (p = 0.222) were found.Conclusion: This observational study showed how bilateral partial variant and bilateral complete variant are the most represented morphotypes in all the age groups. The prevalence of MCI is positively associated with PP and with SB.

Dental follicles promote soft tissue management in surgical exposure of labially impacted maxillary canine

Background The present study aimed to report a technically improved operation on the surgical exposure of labially impacted maxillary canine, elaborating the management of soft tissue to achieve better aesthetic results, and post-treatment periodontal health. Methods Patients sought orthodontic treatment with unilateral labially impacted maxillary canines were selected in this study. The impacted teeth were assigned to the experimental group and contralateral unimpacted canines were assigned to the control group. The impacted canines were surgically exposed with dissected dental follicle (DF) stitching to muscle and mucosa surrounding the crowns. The gingival index (GI), probing depth (PD), the width of the keratinized gingiva (WKG), gingival scars (GS), bone loss (BL), and apical root resorption (ARR) were recorded after the removal of the fixed appliance. A two-sample t-test was used for independent samples for parametric variables. Results A total of 24 patients with unilateral maxillary canine impaction were successfully treated. The outcomes of GI, WKG, GS, BL, and ARR did not indicate statistical significance between the experimental group and the control group. Conclusions The preservation of DF promotes soft tissue management in combined surgical and orthodontic treatment of labially impacted maxillary canine to achieve better periodontal status. Trial Registration Chinese Clinical Trial Registry ChiCTR2000029091, 2020-01-12.