Interceptive Measures For Canines

One of the most significant publications in the orthodontic literature came from Ericson & Kurol (1988)1 who demonstrated that extraction of upper deciduous canines where the upper permanent canines were developing on the palatal aspect, resulted in nearly an 80% chance of correcting the impaction. The paper was very specific about what types of malocclusions this could be applied to. Nearly all the cases were Class I with no incisor crowding. This is important to emphasise, a subsequent follow-up paper2 confirmed their original observation and also indicated that the technique could not be applied easily to crowded cases and in some cases this would result in a worsening of the situation rather than an improvement. The dental pantomogram of a patient is shown in Figure 9. The canines are palatally positioned. Since this was an uncrowded case, the deciduous canines were extracted and Figure 10 shows that both the

Ericsson Kurol

Fig. 8 Dental pantomogram of a patient who had had all four first premolars removed without sufficient diagnostic information. The upper permanent canines are in a very poor position and with the distinct possibility of some root resorption it was felt that the upper permanent canines should be removed and replaced prosthetically

Fig. 8 Dental pantomogram of a patient who had had all four first premolars removed without sufficient diagnostic information. The upper permanent canines are in a very poor position and with the distinct possibility of some root resorption it was felt that the upper permanent canines should be removed and replaced prosthetically

Fig. 9 Dental pantomogram of a patient with palatally impacted canines
Fig. 10 The same patient as in Figure 9. The dental pantomogram clearly shows that both canines have disimpacted and are now erupting in the line of the arch. The only active treatment was extraction of both upper deciduous canines
Fig. 11 Palatally impacted canines which have had a flap raised and gold chain bonded to the crowns of the permanent canines
Picture Orthodontic Gold Chain
Fig. 12 A bucally positioned canine has had a gold chain attached but in an incorrect position. The chain should exit mid alveolus and from keratinised mucosa

permanent canines erupted with no orthodontic assistance. Clearly this saved the patient a considerable amount of treatment and early appropriate referral would be wise if a general dental practitioner is unsure. The interceptive measure of extracting deciduous canines works well if carried out between the ages of 11-13 years. The closer the crowns are to the mid-line the worse the prognosis. It is worth re-emphasising that this works best in Class I uncrowded cases.

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