Maxillary canine impaction is a common dental anomaly where the permanent canine tooth fails to erupt into the dental arch. There are several proposed theories for the causes of canine impaction, including lack of guidance from adjacent teeth, insufficient arch length, genetic factors, and systemic conditions. Canine impactions can be classified based on their position, depth, and angulation. Clinical examination and radiographs are used to diagnose impacted canines. Radiographic views like panoramic, periapical, and occlusal films provide information on tooth development and position to determine the appropriate treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses open bite, including definitions, classifications, anterior open bite (AOB), and posterior open bite (POB). It defines open bite as a malocclusion where there is no vertical overlap between the maxillary and mandibular anterior or posterior teeth. AOB is more common than POB and can be caused by factors like thumb sucking, increased vertical facial proportions, tongue posture, mouth breathing, and neurological issues. Diagnosis involves assessing medical history and performing tests like the Overbite Depth Indicator. Treatment aims to correct the underlying causes and close the open bite.
COGS analysis (Cephelometrics for orthognathic surgery) / fixed orthodontics ...Indian dental academy
This document provides an overview of the COGS (Cephalometrics for Orthognathic Surgery) analysis. It begins with an introduction to cephalometrics and then describes the various landmarks, measurements, and analyses used in COGS. The COGS analysis examines both hard and soft tissues, including cranial base, skeletal, dental, soft tissue, and facial forms analyses. It uses linear and angular measurements to evaluate features like jaw positions, facial heights and widths, tooth angulations, and overall facial contour. The document outlines the typical landmarks, reference planes, and normative values for each measurement in the COGS analysis.
This document discusses the classification, causes, and treatment options for Class II and Class III malocclusions. It begins with an overview of Class II malocclusions, including the dental and skeletal classifications. Common causes are discussed, such as heredity and environmental factors. Treatment options for Class II malocclusions include camouflage with orthodontics alone, extraction of premolars with orthodontics, and distalization of maxillary molars with appliances or temporary skeletal anchorage. Class III malocclusions are also briefly covered, discussing etiology, classification, and treatment including camouflage or surgical options.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document discusses different types of headgears used in orthodontic treatment including cervical headgear, high-pull headgear, combination headgear, and headgear attached to the lower jaw. It explains how the position of the outer bow relative to the center of resistance and line of force determines the direction of tooth movement and effects on the occlusal plane. Intrusive, extrusive, clockwise, and counterclockwise moments can be created by adjusting the outer bow position. The timing and indications for different headgear types are also covered.
Frankles appliance Is a myofunctional appliance
Functional appliance are removable or fixed appliances that aim to utilize eliminate or guide the forces arising from muscle function,tooth eruption and growth inorder to alter skeletal and dental relationship
Canine Impaction and Its Importance in OrthodonticsAnalhaq Shaikh
Canine Impaction, Its Importance in Orthodontics, Etiology, Diagnosis and Management.
by Dr Analhaq Shaikh, 2nd year Postgraduate student, Sharavathi Dental College and Hospital, Shimoga, Karnataka
Canine Impaction can also be termed as Shy Canine.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses open bite, including definitions, classifications, anterior open bite (AOB), and posterior open bite (POB). It defines open bite as a malocclusion where there is no vertical overlap between the maxillary and mandibular anterior or posterior teeth. AOB is more common than POB and can be caused by factors like thumb sucking, increased vertical facial proportions, tongue posture, mouth breathing, and neurological issues. Diagnosis involves assessing medical history and performing tests like the Overbite Depth Indicator. Treatment aims to correct the underlying causes and close the open bite.
COGS analysis (Cephelometrics for orthognathic surgery) / fixed orthodontics ...Indian dental academy
This document provides an overview of the COGS (Cephalometrics for Orthognathic Surgery) analysis. It begins with an introduction to cephalometrics and then describes the various landmarks, measurements, and analyses used in COGS. The COGS analysis examines both hard and soft tissues, including cranial base, skeletal, dental, soft tissue, and facial forms analyses. It uses linear and angular measurements to evaluate features like jaw positions, facial heights and widths, tooth angulations, and overall facial contour. The document outlines the typical landmarks, reference planes, and normative values for each measurement in the COGS analysis.
This document discusses the classification, causes, and treatment options for Class II and Class III malocclusions. It begins with an overview of Class II malocclusions, including the dental and skeletal classifications. Common causes are discussed, such as heredity and environmental factors. Treatment options for Class II malocclusions include camouflage with orthodontics alone, extraction of premolars with orthodontics, and distalization of maxillary molars with appliances or temporary skeletal anchorage. Class III malocclusions are also briefly covered, discussing etiology, classification, and treatment including camouflage or surgical options.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document discusses different types of headgears used in orthodontic treatment including cervical headgear, high-pull headgear, combination headgear, and headgear attached to the lower jaw. It explains how the position of the outer bow relative to the center of resistance and line of force determines the direction of tooth movement and effects on the occlusal plane. Intrusive, extrusive, clockwise, and counterclockwise moments can be created by adjusting the outer bow position. The timing and indications for different headgear types are also covered.
Frankles appliance Is a myofunctional appliance
Functional appliance are removable or fixed appliances that aim to utilize eliminate or guide the forces arising from muscle function,tooth eruption and growth inorder to alter skeletal and dental relationship
Canine Impaction and Its Importance in OrthodonticsAnalhaq Shaikh
Canine Impaction, Its Importance in Orthodontics, Etiology, Diagnosis and Management.
by Dr Analhaq Shaikh, 2nd year Postgraduate student, Sharavathi Dental College and Hospital, Shimoga, Karnataka
Canine Impaction can also be termed as Shy Canine.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
orthodonticTraction of impacted maxillary canine and Piggyback techniquemohammed alawdi
This document discusses impacted maxillary canines. It notes that canines are commonly impacted palatally, with females more often affected than males. Clinical signs of an impacted canine include delayed eruption of the permanent canine or prolonged retention of the deciduous canine. Impacted canines can be located using radiographs. Treatment involves either open or closed surgical exposure techniques followed by orthodontic forces to erupt the canine into alignment. Forces are typically applied using cantilever springs or the Kilroy spring. Case examples demonstrate successful treatment of palatally and buccally impacted canines using these approaches.
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
Ceph tracing allows for quantitative analysis of dental and skeletal structures to describe morphology, diagnose deviations, plan treatment, and evaluate changes over time. Key aspects of cephalometric analysis include identification of anatomical landmarks, angular and linear measurements of cranial structures, maxilla, mandible, and dentition. Several common analyses were described, including Steiner, Downs, Tweed, Bjork, Jarabak, Ricketts, and McNamara analyses, each with their own sets of angular measurements and norms. Ceph tracing is useful for orthodontic diagnosis and treatment planning.
The document discusses various concepts related to mandibular growth rotations proposed by different orthodontic researchers over time. It begins by introducing Arne Bjork who first described growth rotations in 1955. It then covers Enlow's concept of remodeling and displacement rotations. Bjork's 1969 classification of forward and backward mandibular rotations is described, including his identification of three types of forward and two types of backward rotations based on their center of rotation. The document also discusses concepts by Bjork and Skieller on total, matrix, and intramatrix rotations. Fred Schudy's concept relating rotation to the disharmony between vertical, anteroposterior and horizontal growth is summarized. Finally, Dibbets' re
This document discusses the diagnosis and treatment of Class III malocclusions. It begins with definitions and features of Class III malocclusions, noting they involve a mesial relationship of the mandible to the maxilla. Treatment approaches are described for:
1. Intercepting Class III malocclusions during growth using myofunctional appliances, chin cups, or face masks to redirect growth.
2. Using fixed appliances in mixed dentition to retrocline lower incisors and procline upper incisors.
3. Addressing anterior and posterior crossbites.
4. Considering extractions for mild mandibular prognathism.
5. Surgical-orthodontic treatment
Introduction
Incidence
Development of canine
Eruption of canine
Etiology of canine impaction
Sequelae of canine impaction
Classification of canine impaction
Diagnosis
Radiographic Prediction
Prognosis
Prevention of maxillary impaction
Extraction of impacted canine
Treatment alternatives
General principles of mechanotherapy
Methods of gaining space
Anchorage considerations
Surgical Methods
Surgical exposure for natural eruption
One step vs two step
Types of flaps
Attachments
Methods of traction
Mandibular canine impaction
Canine impaction and resorption
Canine impaction and periodontium
Retention
Complications of treatment
Complications of untreated impacted canine
Conclusions
References
Rotated teeth can be corrected using fixed or removable appliances. With fixed appliances, various ligation techniques can be used to apply rotational forces, including double ligation which ties one bracket loosely and the other firmly. NiTi wires or loops can also be used to derotate teeth around their long axis. Removable appliances are generally not suitable for correcting severe rotations of teeth with rounded crowns like premolars and canines due to the inability to apply proper rotational forces. Early correction of rotations is preferable before root completion to aid retention.
The document discusses Bjork's concept of jaw rotation during growth. It summarizes Bjork's landmark longitudinal study from 1951-1969 that used metal implants to track sites of growth and resorption in the mandible. Bjork observed that the mandible undergoes a downward and backward rotation during growth, with greater growth occurring posteriorly than anteriorly. He classified mandibular rotation patterns into forward and backward types based on the center of rotation. The study provided insights into mandibular growth mechanisms and implications for orthodontic treatment planning.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses various types of intrusion arches used in orthodontics to correct deep overbites. It begins by defining intrusion and describing the biomechanics and principles involved. It then covers 9 specific intrusion arch designs: 1) Rickett's Utility Arch 2) Tipback Springs 3) Burstone's Continuous Intrusion Arch 4) Burstone's Three Piece Intrusion Arch 5) K-SIR 6) Connecticut Intrusion Arch 7) PG Retraction Spring 8) Translation Arch 9) Lingual Arch for intruding lower incisors. For each type, it provides details on materials, design, and mechanics of intrusion.
This document discusses the management of impacted canines. It begins with definitions and the most commonly impacted teeth. It then covers the incidence, classification, etiology, theories, localization, and prognosis of canine impactions. Regarding management, it discusses interceptive treatment, surgical exposure techniques for labial and palatal impactions, methods of applying orthodontic traction, and retention considerations. Radiographic diagnosis methods including periapical films, occlusal views, parallax technique, and CT are also summarized.
An impacted tooth is one that fails to erupt into the dental arch at the proper time. Wisdom teeth and canines are most commonly impacted. Canine impaction occurs in 2% of people and is more common in females. It is caused by overcrowding or issues during tooth development. Impacted canines can cause problems like cysts, infections, and damage to nearby teeth if not treated. Treatment options include exposing and orthodontically moving the tooth, extraction, or leaving it with monitoring. Proper diagnosis and management of impacted canines is important for dental health and aesthetics.
Maxillary canine impaction is a common orthodontic problem that requires a multidisciplinary approach. Impacted canines can occur for localized reasons such as arch length discrepancies or systemic/genetic factors. Treatment involves surgical exposure followed by orthodontic alignment and may require prolonged retention. Factors such as canine position, available space, and patient age influence the specific treatment approach and prognosis.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The general indications for SARPE are skeletal maturity, transverse maxillary deficiency, excessive display of buccal corridors when smiling, and anterior crowding.
This document discusses Class II Division 2 malocclusion. It begins by introducing Edward Hartley Angle, the father of modern orthodontics. It then defines Class II Division 2 malocclusion as a type of Class II malocclusion where the maxillary molars are mesially positioned relative to the mandibular molars. The document covers the etiology, features, diagnosis and treatment of Class II Division 2 malocclusion, noting that it can be caused by dental factors like tooth size discrepancies or skeletal factors like mandibular deficiency or maxillary excess. Muscular patterns are also discussed, noting that strong muscles may not allow proper bite opening in adult patients with this malocclusion.
The document discusses open bite, which is a malocclusion characterized by a lack of vertical overlap between the maxillary and mandibular teeth. It defines open bite, classifies it as anterior or posterior open bite, and discusses its various etiologies such as disturbances in eruption, mechanical interference, mouth breathing, tongue thrusting, and thumb sucking. The document outlines considerations for open bite diagnosis and treatment approaches including appliances, functional therapy, orthodontic treatment, and in some cases surgery. It provides details on managing open bite at different stages of dentition using various techniques and appliances.
Dr. James McNamara developed a cephalometric analysis method in 1984 to evaluate orthodontic and orthognathic surgery patients. The analysis divides the craniofacial skeleton into five sections - maxilla to cranial base, maxilla to mandible, mandible to cranial base, dentition, and airway. Linear measurements of landmarks and planes are compared to normative standards to assess relationships. Advantages include using primarily linear measurements, being more sensitive to vertical changes, and providing growth guidelines that are easily explained.
Ricketts analysis /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Canine impaction maxillary teeth part 2VilvaKarthick
This document discusses maxillary canine impactions. It begins by discussing the incidence, locations, and classifications of impacted canines. Several theories for the etiology of palatally and labially impacted canines are described, including the Beckers Concept, McBridge Concept, Moyers Concept, and Von Der Heyedt Concept. Indications and contraindications for removal of impacted canines are provided. Various classification systems for impacted canines including Fields and Ackerman, Archer, and Yamamoto are explained. Methods for localizing impacted canines including inspection, palpation, and different radiographic views are covered. Complicating factors and prognostic factors are also summarized.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
orthodonticTraction of impacted maxillary canine and Piggyback techniquemohammed alawdi
This document discusses impacted maxillary canines. It notes that canines are commonly impacted palatally, with females more often affected than males. Clinical signs of an impacted canine include delayed eruption of the permanent canine or prolonged retention of the deciduous canine. Impacted canines can be located using radiographs. Treatment involves either open or closed surgical exposure techniques followed by orthodontic forces to erupt the canine into alignment. Forces are typically applied using cantilever springs or the Kilroy spring. Case examples demonstrate successful treatment of palatally and buccally impacted canines using these approaches.
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
Ceph tracing allows for quantitative analysis of dental and skeletal structures to describe morphology, diagnose deviations, plan treatment, and evaluate changes over time. Key aspects of cephalometric analysis include identification of anatomical landmarks, angular and linear measurements of cranial structures, maxilla, mandible, and dentition. Several common analyses were described, including Steiner, Downs, Tweed, Bjork, Jarabak, Ricketts, and McNamara analyses, each with their own sets of angular measurements and norms. Ceph tracing is useful for orthodontic diagnosis and treatment planning.
The document discusses various concepts related to mandibular growth rotations proposed by different orthodontic researchers over time. It begins by introducing Arne Bjork who first described growth rotations in 1955. It then covers Enlow's concept of remodeling and displacement rotations. Bjork's 1969 classification of forward and backward mandibular rotations is described, including his identification of three types of forward and two types of backward rotations based on their center of rotation. The document also discusses concepts by Bjork and Skieller on total, matrix, and intramatrix rotations. Fred Schudy's concept relating rotation to the disharmony between vertical, anteroposterior and horizontal growth is summarized. Finally, Dibbets' re
This document discusses the diagnosis and treatment of Class III malocclusions. It begins with definitions and features of Class III malocclusions, noting they involve a mesial relationship of the mandible to the maxilla. Treatment approaches are described for:
1. Intercepting Class III malocclusions during growth using myofunctional appliances, chin cups, or face masks to redirect growth.
2. Using fixed appliances in mixed dentition to retrocline lower incisors and procline upper incisors.
3. Addressing anterior and posterior crossbites.
4. Considering extractions for mild mandibular prognathism.
5. Surgical-orthodontic treatment
Introduction
Incidence
Development of canine
Eruption of canine
Etiology of canine impaction
Sequelae of canine impaction
Classification of canine impaction
Diagnosis
Radiographic Prediction
Prognosis
Prevention of maxillary impaction
Extraction of impacted canine
Treatment alternatives
General principles of mechanotherapy
Methods of gaining space
Anchorage considerations
Surgical Methods
Surgical exposure for natural eruption
One step vs two step
Types of flaps
Attachments
Methods of traction
Mandibular canine impaction
Canine impaction and resorption
Canine impaction and periodontium
Retention
Complications of treatment
Complications of untreated impacted canine
Conclusions
References
Rotated teeth can be corrected using fixed or removable appliances. With fixed appliances, various ligation techniques can be used to apply rotational forces, including double ligation which ties one bracket loosely and the other firmly. NiTi wires or loops can also be used to derotate teeth around their long axis. Removable appliances are generally not suitable for correcting severe rotations of teeth with rounded crowns like premolars and canines due to the inability to apply proper rotational forces. Early correction of rotations is preferable before root completion to aid retention.
The document discusses Bjork's concept of jaw rotation during growth. It summarizes Bjork's landmark longitudinal study from 1951-1969 that used metal implants to track sites of growth and resorption in the mandible. Bjork observed that the mandible undergoes a downward and backward rotation during growth, with greater growth occurring posteriorly than anteriorly. He classified mandibular rotation patterns into forward and backward types based on the center of rotation. The study provided insights into mandibular growth mechanisms and implications for orthodontic treatment planning.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses various types of intrusion arches used in orthodontics to correct deep overbites. It begins by defining intrusion and describing the biomechanics and principles involved. It then covers 9 specific intrusion arch designs: 1) Rickett's Utility Arch 2) Tipback Springs 3) Burstone's Continuous Intrusion Arch 4) Burstone's Three Piece Intrusion Arch 5) K-SIR 6) Connecticut Intrusion Arch 7) PG Retraction Spring 8) Translation Arch 9) Lingual Arch for intruding lower incisors. For each type, it provides details on materials, design, and mechanics of intrusion.
This document discusses the management of impacted canines. It begins with definitions and the most commonly impacted teeth. It then covers the incidence, classification, etiology, theories, localization, and prognosis of canine impactions. Regarding management, it discusses interceptive treatment, surgical exposure techniques for labial and palatal impactions, methods of applying orthodontic traction, and retention considerations. Radiographic diagnosis methods including periapical films, occlusal views, parallax technique, and CT are also summarized.
An impacted tooth is one that fails to erupt into the dental arch at the proper time. Wisdom teeth and canines are most commonly impacted. Canine impaction occurs in 2% of people and is more common in females. It is caused by overcrowding or issues during tooth development. Impacted canines can cause problems like cysts, infections, and damage to nearby teeth if not treated. Treatment options include exposing and orthodontically moving the tooth, extraction, or leaving it with monitoring. Proper diagnosis and management of impacted canines is important for dental health and aesthetics.
Maxillary canine impaction is a common orthodontic problem that requires a multidisciplinary approach. Impacted canines can occur for localized reasons such as arch length discrepancies or systemic/genetic factors. Treatment involves surgical exposure followed by orthodontic alignment and may require prolonged retention. Factors such as canine position, available space, and patient age influence the specific treatment approach and prognosis.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The general indications for SARPE are skeletal maturity, transverse maxillary deficiency, excessive display of buccal corridors when smiling, and anterior crowding.
This document discusses Class II Division 2 malocclusion. It begins by introducing Edward Hartley Angle, the father of modern orthodontics. It then defines Class II Division 2 malocclusion as a type of Class II malocclusion where the maxillary molars are mesially positioned relative to the mandibular molars. The document covers the etiology, features, diagnosis and treatment of Class II Division 2 malocclusion, noting that it can be caused by dental factors like tooth size discrepancies or skeletal factors like mandibular deficiency or maxillary excess. Muscular patterns are also discussed, noting that strong muscles may not allow proper bite opening in adult patients with this malocclusion.
The document discusses open bite, which is a malocclusion characterized by a lack of vertical overlap between the maxillary and mandibular teeth. It defines open bite, classifies it as anterior or posterior open bite, and discusses its various etiologies such as disturbances in eruption, mechanical interference, mouth breathing, tongue thrusting, and thumb sucking. The document outlines considerations for open bite diagnosis and treatment approaches including appliances, functional therapy, orthodontic treatment, and in some cases surgery. It provides details on managing open bite at different stages of dentition using various techniques and appliances.
Dr. James McNamara developed a cephalometric analysis method in 1984 to evaluate orthodontic and orthognathic surgery patients. The analysis divides the craniofacial skeleton into five sections - maxilla to cranial base, maxilla to mandible, mandible to cranial base, dentition, and airway. Linear measurements of landmarks and planes are compared to normative standards to assess relationships. Advantages include using primarily linear measurements, being more sensitive to vertical changes, and providing growth guidelines that are easily explained.
Ricketts analysis /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Canine impaction maxillary teeth part 2VilvaKarthick
This document discusses maxillary canine impactions. It begins by discussing the incidence, locations, and classifications of impacted canines. Several theories for the etiology of palatally and labially impacted canines are described, including the Beckers Concept, McBridge Concept, Moyers Concept, and Von Der Heyedt Concept. Indications and contraindications for removal of impacted canines are provided. Various classification systems for impacted canines including Fields and Ackerman, Archer, and Yamamoto are explained. Methods for localizing impacted canines including inspection, palpation, and different radiographic views are covered. Complicating factors and prognostic factors are also summarized.
Maxillary canine impaction / oral surgery courses /certified fixed orthodon...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
This document discusses maxillary canine impaction, including its classification, causes, diagnosis, and treatment options. It provides an overview of the development and eruption path of maxillary canines. Common causes of impaction include lack of guidance from lateral incisors and insufficient arch length. Diagnosis involves radiography such as panoramic x-rays and CT scans to determine the three-dimensional position. Treatment options discussed include surgical exposure and applying traction to erupt the canine either buccally or palatally depending on its position.
This document discusses canine impaction, including its causes, prevalence, classification, diagnosis, and management. It begins by introducing canine impaction and noting that it is usually diagnosed during routine dental exams. It then covers developmental considerations, etiology, prevalence, potential sequelae, and various classification systems for impacted maxillary and mandibular canines. The document outlines methods for clinical and radiographic diagnosis, and concludes by discussing various treatment options for impacted canines, including no treatment, interceptive treatment, extraction, auto transplantation, and surgical exposure with orthodontic alignment.
Maxillary canine impaction 02 /certified fixed orthodontic courses by Indian ...Indian dental academy
This document discusses maxillary canine impaction and its management. It begins by defining impacted teeth and noting that maxillary canines are among the most commonly impacted teeth. It then covers the development and eruption path of canines, classifications of impaction, and various theories for the causes of impaction. The document discusses clinical and radiographic evaluation methods for diagnosing impaction. It outlines treatment options for impacted canines, including surgical exposure and orthodontic alignment.
This document provides an overview of impacted teeth and their surgical management. It begins with definitions of impacted, unerupted, and malposed teeth. It then discusses the etiology, theories of impaction, indications for surgery, classifications, and assessments needed prior to surgery. Surgical management involves raising a flap, removing overlying bone, and extracting the tooth. Potential complications during and after surgery are also reviewed.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
presentation about impacted canine incidence, prevalence,classification,diagnosis, localization and treatment options including surgical and non surgical modalities
This document summarizes impacted teeth, focusing on commonly impacted teeth like third molars, maxillary third molars, and maxillary cuspids. It discusses causes of impaction like genetic factors, localized obstructions, and systemic issues. Diagnosis involves history, examination, palpation, percussion, and various radiographic techniques. Management depends on the specific tooth and can include no treatment, interceptive extraction, surgical exposure with orthodontics, surgical removal, or transplantation. Prognosis is related to factors like position, angulation, overlap with adjacent teeth, and degree of displacement.
This document summarizes impacted teeth, focusing on commonly impacted teeth like third molars, maxillary third molars, and maxillary cuspids. It discusses causes of impaction like genetic factors, localized obstructions, and systemic issues. Diagnosis involves history, examination, palpation, percussion, and various radiographic techniques. Management depends on the specific tooth and can include no treatment, interceptive extraction, surgical exposure with orthodontics, surgical removal, or transplantation. Maxillary canines, central incisors, and mandibular second premolars are discussed in more depth regarding their presentation, investigation, and treatment approaches.
1. Tooth impaction occurs when a tooth fails to erupt into its normal functional position due to a physical barrier or ectopic position. Maxillary and mandibular third molars are most commonly impacted.
2. Factors that can cause impaction include lack of space, abnormal tooth angulation, obstruction of the eruption pathway, late tooth mineralization, and genetic/systemic conditions.
3. Impacted mandibular third molars pose surgical challenges due to their location near important anatomical structures like the inferior alveolar nerve. Their position must be carefully evaluated radiographically prior to removal.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document summarizes information about impacted teeth. It begins by defining an impacted tooth and listing the most common sites of impaction. It then discusses several theories for the causes of impaction, including lack of space from small jaws, heredity, pathology, endocrinology, and nature versus nurture. Risk factors and classifications of impacted teeth are also outlined. The document provides details on the rationale for removal, contraindications, surgical techniques, complications, and postoperative care for impacted teeth.
Maxillary canine impaction occurs when the canine tooth fails to erupt into its proper position. This document discusses the development, eruption process and factors that can cause impaction of the canine tooth. It also covers methods for diagnosing impaction including various radiographic techniques and indices. The prognosis depends on the severity of impaction, as determined by radiographic evaluation, with more severe impactions requiring more complex treatment such as surgical exposure or extraction.
The document discusses impacted teeth and their surgical management. It defines an impacted tooth as one that is partially or fully unerupted due to a physical barrier. The most common impacted teeth are third molars and maxillary canines. It describes several classification systems for impacted third molars based on their position, depth, and relationship to other teeth. Indications for surgical removal include pericoronitis, cysts/tumors, and facilitating orthodontic treatment. Key anatomical landmarks discussed are the mandible, inferior alveolar nerve and vessels, retromolar triangle, and lingual and mylohyoid nerves.
This document discusses tooth impaction, which occurs when a tooth is unerupted or malpositioned against another tooth, bone, or soft tissue beyond its normal eruption time. The most common impacted teeth are mandibular and maxillary third molars, followed by maxillary canines. Causes of impaction include genetics, small jaw size, dental anomalies, systemic conditions, and local factors. Impacted teeth are classified based on their position, relationship to other teeth, and degree of bone coverage. Surgical removal may be needed to address related issues like pericoronitis or to allow proper eruption of other teeth.
The document reviews various methods for localizing impacted canines, noting that early diagnosis is important to prevent impaction. Clinical examination and various radiographic techniques like panoramic radiographs, periapical views, and cephalograms can be used to locate displaced canines. Advanced 3D imaging modalities like CT, spiral CT, and CBCT are also discussed which provide more accurate 3D localization of impacted canines compared to conventional 2D radiography.
1) Angle's Class II division 2 malocclusion is characterized by a Class II molar relationship due to retroclination of the maxillary incisors. 2) Etiology can include a skeletal Class II pattern due to a retrognathic mandible or influence of soft tissue habits. 3) Treatment options include growth modification, dental camouflage, or orthognathic surgery depending on the severity of the skeletal discrepancy and dental crowding.
Lasers in oral and maxillofacial surgery Jeff Zacharia
This document discusses lasers used in oral and maxillofacial surgery. It begins with an introduction to lasers and their properties. It then covers the history of lasers, the components of a laser unit including the active medium and resonator cavity. It classifies lasers based on their active medium and wavelength and discusses their indications for soft and hard tissue procedures. Examples of surgical uses include cleft surgery, TMJ surgery, intraoral lesions, and implantology. Precautions for safe use and the selection of appropriate lasers are also outlined.
This document discusses various induction agents used in general anesthesia. It begins by defining general anesthesia and its key features. It then covers general principles of pharmacology relevant to induction agents, including their action on receptors, plasma protein binding, crossing the blood-brain barrier, and distribution to other tissues. The document classifies common intravenous induction agents and discusses in detail the properties, mechanisms, uses, and adverse effects of thiopental sodium, propofol, and etomidate.
This document discusses dead space management and wound dressings. It defines dead space as any area remaining devoid of tissue after wound closure. Dead space can lead to hematoma formation and increased risk of infection if not properly managed. Methods to eliminate dead space include suturing tissue planes, applying pressure dressings, packing wounds, and using surgical drains. The document then describes different types of drains and their classifications, as well as potential complications. It also discusses wound dressing materials, their purposes and properties.
This document provides information on the Ramus osteotomy procedure, specifically the sagittal split osteotomy (SSO). It discusses the history and evolution of the SSO technique from its early developments to modern procedures. Key steps of the current SSO procedure are outlined, including incision, dissection, identification of anatomical landmarks, and performing the osteotomies along the medial ramus, vertical body, and buccal cortex before splitting the mandible. The SSO allows correction of mandibular deformities by repositioning the proximal and distal segments.
This document provides an overview of primary care in trauma. It discusses the primary and secondary surveys, with a focus on assessing and managing the ABCs - Airway, Breathing, and Circulation. For the airway, it describes techniques for opening and maintaining the airway as well as mechanical airway devices and surgical procedures. For breathing, it discusses signs of respiratory distress and management of pneumothorax, hemothorax, and flail chest. For circulation, it outlines assessing pulses, capillary refill, and skin signs to evaluate circulation and control hemorrhage. The goal is to accurately and systematically assess and address any immediate life threats.
The document discusses condylar fractures, including:
- Anatomy of the condyle and temporomandibular joint
- Various classifications of condylar fractures
- Clinical features like swelling, pain, and limited jaw movement
- Diagnosis using radiographs like panoramic x-rays and CT scans
- Treatment approaches like closed or open reduction
- Indications for non-surgical versus surgical management
In 3 sentences it summarizes that the document discusses the anatomy, classifications, diagnosis, and treatment approaches like closed or open reduction for condylar fractures of the temporomandibular joint.
The document provides information on the facial nerve (cranial nerve VII), including its embryology, nuclei, course, branches, landmarks, neurophysiology, causes of damage, and grading systems for facial palsy. It describes the facial nerve's development during gestation, its motor, sensory and parasympathetic functions. Key points along its intra- and extracranial course are identified. Variations, injuries, and resulting functional deficits are also discussed.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
4. Introduction
With the exception of the third molar, maxillary canine impaction is considered to be the most
common form of tooth impaction. The position of the permanent maxillary canine at the angle of
the mouth is strategically important in preserving the harmony and symmetry of the dental arches.
The incidence of canine impaction in the maxilla is more than twice higher compared to the
mandible. Approximately one-thirds of the cases are labially located, and two-thirds are palatally
located. Bilateral impaction have been reported in 8% of the patients with canine impaction. The
treatment procedure is time-consuming and imposes a significant financial burden on the patient
5. Impacted Tooth
◦ A tooth which is completely or partially unerupted, is positioned against another tooth, bone or
soft tissue so that its further eruption is unlikely and described according to anatomic position
(Archer)
◦ An impacted tooth is defined as a tooth that is prevented from erupting into position because of
malposition, lack of space or other impediments. (Mead 1954)
◦ Impacted teeth are those teeth that fail to erupt into the dental arch within the expected time. (Peterson)
◦ Impacted teeth are those teeth that are prevented from eruption due to a physical barrier within the path of eruption
(Farman 2004)
7. Concepts maxillary canine impaction
Becker Concept
Becker (1984) hypothesized two processes in palatal impaction of the maxillary canine:
1. Absence of initial early guidance from an anomalous lateral incisor
2. Failure of buccal movement of the canine at an unspecified age .
MC Bridge Concept
Canine formed at high level in the anterior wall of antrum, below the floor of orbit have a tortous path
of eruption
8. Moyers Concept: Summarized by Bishara
A) Primary cause:
1) Trauma to decidious tooth bud
2) Rate of Resorption of decidious tooth
3) Availability of space in the arch
4) Disturbance in tooth Eruption Sequence
5) Rotation of tooth buds
6) In Cleft area of cleft patient
7) Premature root Closure
B) Secondary cause:
1) Abnormal muscle pressure
2) Febrile diseases
3) Endocrine disturbances
4) Vitamin D deficiency.
AJO. 1992.Feb.Bishara
9. 1) Malnutrition
2) Tuberculosis
3) Syphilis
4) Rickets
5) Anemia
6) Progeria
7) Syndromes:
a) Cleidocranial dysplasia
b) Achondraplasia
c) Down syndrome
Berger Concept (Systemic causes of impaction)
10. Vonder Heydt Concept
“The total arch length for the permanent teeth is primarily established very early in life at
the time of eruption of the first permanent molars, and because the canine is large and late
in eruption, it is often not found in the alignment of the arch.
As in musical chairs, the room for this tooth is all gone, and it must assume an awkward and
embarrassingly inappropriate position on the arch alignment.”
11. Miller’s Guidance Theory
According to the guidance theory, the presence of the lateral incisor root with right length and formed at the
right time are important variables needed to guide the mesially erupting canine in a more favorable distal and
incisal direction.
If excessive space exists due to malformed or absent lateral incisor, the canine would cross back from the
buccal to the palatal side behind the buds of the other teeth.
12. Genetic Theory
This theory indicates multiple evidential categories for the genetic origin of palatally impacted canines,
such as: Familial and bilateral occurrence, Sex differences, as well as an increased occurrence of other
significant reciprocal dental associations such as ectopic eruption of first molars, infraocclusion of
primary molars, aplasia of premolars and one third molar.
Pirinen et al., showed that 106 patients with palatally displaced canines had first and second degree relatives with some
dental anomalies.
14. Classification of impacted maxillary canine
BASED ON POSITION IN THE DENTAL ARCH
CLASS I: Impacted cuspids in palate
1. Horizontal
2. Vertical
3. Semi-vertical
CLASS II: Impacted cuspids on buccal surface
1. Horizontal
2. Vertical
3. Semi-vertical
15. CLASS III: Impacted cuspids located in the palatal
process and labial maxillary bone
CLASS IV: Impacted cuspids located in the alveolar
process usually vertically between the incisor and
bicuspid
CLASS V: Impacted cuspid located in an edentulous
maxilla
16. FIELD AND ACKERMAN CLASSIFICATION (1935)
MAXILLARY CANINES
Labial position
1. Crown in intimate relationship with incisors
2. Crown well above the apices of incisors
Palatal position
1. Crown near the surface, in close relationship to
roots of incisors
2. Crown deeply embedded in close relationship to
apices of incisors.
Intermediate position
1. Crown is between lateral incisors and 1st premolar
roots.
2. Crown above these teeth where it is labially placed
and root is palatally placed or vice versa
Unusual positions
1. In nasal or antral wall.
2. In infraorbital region
17. Unusual positions
1. At inferior border
2. In mental protuberance
3. Migrated to the opposite side along with the original
nerve supply
Labial position
1. Vertical
2. Oblique
3. Horizontal
MANDIBULAR CANINES
18. Ericson and Kurol (1988) classification
Sector 1: if the cusp tip of the canine is between the inter-
incisor median line and the long axis of the central incisor
Sector 2: if the peak of the cuspid of the canine is between
the major axes of the lateral and central
Sector 3: if the peak of the cuspid of the canine is between
the major axis of the lateral and the first premolar.
19. Classification for trans-positioned maxillary canines
According to Peck & Peck (1993)
Maxillary canine–first premolar(Mx.C.P1)
Maxillary canine–lateral incisor (Mx.C.I2),
Maxillary canine–first molar site (Mx.C to M1)
Maxillary lateral incisor–central incisor (Mx.I2.I1)
Maxillary canine–central incisor site (Mx.C to I1)
Mandibular lateral incisor–canine (Mn.I2.C).
20. Classification of impacted mandibular canine
Based on angulation
◦ Mesio-angular
◦ Disto-angular
◦ Vertical
◦ Horizontal
Based on Depth
◦ Level A: The crown of the impacted canine tooth is at the cervical line of the
adjacent teeth
◦ Level B: The crown of the impacted canine tooth is between the cervical line and
root apices of the adjacent teeth.
◦ Level C: The crown of the impacted canines is beneath the root apices of the
adjacent teeth.
Yavuz et all, 2007
21. note: Transmigrated mandibular canine
◦ Transmigration is an intraosseous displacement of an unerupted tooth in which a movement
phenomenon causes it to cross midline by more than 50 % (Mupparapu et al)
◦ It has a prevalence of 0.31% .
Classification: Based on inclination, relationship with the midline, adjacent teeth and contralateral
erupted canine (Mupparapu et al)
Type 1: Canine positioned mesio-angularly with the crown portion of the tooth crossing the
midline.
Type 2: Horizontal impacted canine next to the lower border of the mandible and below the
incisors
Type 3: Mesially or distally eruption of the canine according to the opposite canine.
Type 4: Impacted horizontal canine below of premolars or molars on the contrary side and next
to the lower border of the mandible.
Type 5: Vertical Canine positioned in the midline
23. Clinical Diagnosis
◦ Retention of primary canine in the dental arch beyond the 14th or 15th year of age.
(Becker 1993)
◦ Absence of canine eminence. (Ericsson & Kurol (2000) support the absence of the
canine eminence at the age of 10 – 12 years is not a sign of canine displacement.)
◦ Delayed eruption, distal displacement or distal inclination of lateral incisor. (Becker
1993)
24. Radiographic diagnosis
◦ Clark’s method suggests two periapical radiographs, the second one taken with the device cone
moving horizontally or vertically (Papadopaulous 2004)
◦ Jacobs (1996) recommends the combination of panoramic and occlusal radiographs, where the
cone is positioned vertically at a 70-750 angle.
◦ Use of axial tomography in cases where ankylosis is suspected (Traxler et al, 1989)
◦ The use of OPG offers the possibility for transverse parallel sections of the examined area by
changing the direction of the ray beam. (Broer et al, 2005)
25. Panoramic radiographs
Ericson and Kurol (1988) defined number of sectors to denote
different types of impaction
◦ Sector 1: if the cusp tip of the canine is between the inter-incisor
median line and the long axis of the central incisor
◦ ii. Sector 2: if the peak of the cuspid of the canine is between the
major axes of the lateral and central incisors
◦ iii. Sector 3: if the peak of the cuspid of the canine is between
the major axis of the lateral and the first premolar.
Angle α to represent the angle formed between the inter-incisor
midline and long axis of canine and “d” as the perpendicular distance
of the peak of the cuspid of the impacted canine with respect to the
occlusal plane.
26. ◦ The risk of resorption of the root of the lateral incisor increases by 50% if
the cusp of the canine belongs to sector 1 or 2 and if α angle is greater
than 25°.
◦ Linduaer et al. (1992) found out that 78% of canine were destined to get
impacted when their cusp tips located in sector II, III, IV.
◦ For Orthodontic purpose, The necessity of treatment and the degree of
treatment difficulty increases as this angle increases.
27. Periapical radiographs
simplest radiographs having minimum exposure.
provide us with information regarding
◦ state of development of tooth,
◦ the presence of follicle,
◦ resorption of deciduous tooth.
28. Occlusal view radiograph
◦ Assess whether the canine is impacted in a labial or palatal
position
◦ The X ray beam runs parallel to the long axis of the central
incisors.
◦ The cone is placed over the vertex of the skull to produce the
radiograph.
◦ Since the beam has to travel a great distance, there is loss of clarity
29. PA view
◦ It is used for prognostic evaluation.
◦ Evaluates the medio-lateral position of the canines.
◦ The angle formed between the long axis of the canine and the
transorbital line determines the degree of difficulty. As the angle
between the long axis of the canine and the transorbital line
decreases, the treatment difficulty increases.
30. Lateral cephalogram
◦ This technique is useful in establishing the height of the
impacted tooth and the anteroposterior position of the
canine with respect to the apices of the incisors.
◦ Evaluation of the impacted canine can be done by tracing
its long axis to and intersecting it with the Frankfurt
Horizontal plane.
31. Clark’s Rule or Parallax Method or Tube Shift Method
◦ Parallax is the apparent displacement of an image relative to the image of a reference object and is caused by
an actual change in the angulation of the x-ray beam.
◦ Two radiographs of the object are taken.
◦ First using the proper technique and angulation as prescribed.
◦ second, radiograph is taken keeping all the parameters constant and equivalent of those of the first
radiograph, only changing the direction of the central ray either with a different horizontal angulation or
vertical angulation.
◦ If the tooth shifts in the same direction as the tube then
the tooth is lingually placed and if it moves in the opposite
direction then it is buccally placed (SLOB- same lingual opposite buccal)
32. Right Angle Technique
◦ The right angle technique uses two radiographs taken at right angles to each
other.
◦ Ballard suggested the use of the combination of a lateral cephalometric
radiograph with a postero-anterior cephalometric radiograph for
localization of impacted maxillary canines.
◦ However, the position of the impacted tooth was often difficult to
interpret
◦ Additional intraoral film was required to see the fine detail of the impacted
tooth and its surrounding structures
33. 3-D Techniques: CT & CBCT
It gives information regarding
1. The exact position of the crown and root apex of the impacted tooth and
orientation of the long axis.
2. The proximity of the impacted tooth to the roots of the adjacent teeth.
3. The presence of pathology, such as supernumerary teeth, apical granulomas, or
cysts, and their relationship with the impacted tooth.
4. The presence of adverse conditions affecting adjacent teeth, including root
resorption.
5. The anatomy and position of crown and root
6. Provides excellent tissue contrast and eliminates blurring and overlapping of
adjacent teeth
34. Rapid prototyping
◦ Rapid prototyping aids in the communication between an
orthodontist and a surgeon in treatment planning.
◦ This technique comprises several technologies that use data from
computer-aided design files to produce physical models and devices
by a process of material addition.
36. Treatment Options
No treatment
Surgical removal of unerupted canine
Surgical exposure of the crown with or without orthodontic treatment
Surgical repositioning
Surgical transplantation
37. No treatment (to leave tooth in situ)
Risk of nonintervention
• Crowding of dentition based on growth prediction
• Resorption of adjacent tooth & periodontal status
• Development of pathological conditions such as infection, cyst, tumor.
Benefits of nonintervention
• Avoidance of risk
• Preservation of functional teeth
• Preservation of residual ridge
38. Surgical removal
Indications for surgical removal
◦ Impacted canine is located very far from the occlusal plane
◦ No other methods are possible to retain the tooth
◦ A patient not willing to undergo orthodontic treatment for longer duration
◦ Pathological changes in the crypt like infection, cyst formation, etc
◦ The required space does not exist for the canine tooth in functional position
◦ Because of unfavorable anatomy of the tooth, other methods like repositioning is not likely to be
successful.
Contraindications for Surgical removal
◦ When the cuspid can be brought into normal position surgically or orthodontically.
◦ Medically compromised patients presenting with impacted cuspids.
39. EXTRACTION OF CANINE IN CLASS II POSITION (i.e. labially placed canine)
1. Soft tissue flap is raised
TRAPEZOIDAL FLAP
Advantage:
◦ Provides excellent access
◦ Produces no tension in tissues
◦ Allows easy approximation of the flap to its original position
Disadvantage:
◦ Produces a defect in the attached gingiva
Surgical Technique
For maxillary canines
40. TRIANGULAR FLAP
Advantage:
◦ Ensures adequate blood supply.
◦ Satisfactory visualization
Disadvantage:
◦ Limited access to roots
◦ Tension is created when flap is retracted and results in defect in attached gingiva
SEMI LUNAR FLAP
◦ Used to approach root apex
◦ Avoids trauma to the papilla and gingival margin
◦ Should not cross canine eminence
41. 2. Circumferential bone removal done using chisel or bur to expose crown
3. Elevation of tooth using labial cortical plate used as fulcrum.
43. EXTRACTION OF CANINE IN CLASS I POSITION (i.e. palatally placed canine)
1. Soft tissue flap raised
Surgical Technique
44. 2. Bone removal
Aim of bone removal
To expose the crown by removing the bone overlying it
To remove the bone obstructing the pathway of removal
Amount of bone to be removed
bone is removed circumferentially 3 mm around the crown
the crown is exposed till the CEJ so as to expose it beyond its
greatest width
45. 3. Sectioning of the tooth is done at the level of
the CEJ
4. Elevation of the tooth
impacted tooth is lifted from the crypt using an elevator with
the palatal bone as fulcrum.
if tooth is not luxated, the opening has to be enlarged
5. Wound irrigation & closure
all debris and spicules have to be removed.
flap is compressed on to the palatal bone with a gauze packing
for 4 hours.
Or, a compound stent or clear acrylic plate may be used to
prevent hematoma collection & to maintain sustained pressure
46. EXTRACTION OF CANINE IN CLASS III POSITION (i.e. crown in palate & root on
buccal side)
On the buccal aspect,
1. Soft tissue flap is raised. (Semilunar flap)
2. Circumferential bone removal done.
3. Root sectioning done
On the palatal aspect,
4. Soft tissue flap is raised.
5. Bone removal is done
6. A blunt instrument is placed in contact with the root end on the buccal side and tapped with a mallet which drives
the crown out of the palatal crypt.
47. ◦ Trapezoidal incision extending from the lateral incisor as far as the
first premolar of the opposite side of the arch is made.
◦ Mental nerve has to be identified
◦ Bone removal done using chisel or bur to expose crown.
◦ Elevation of tooth using labial cortical plate used as fulcrum.
◦ Wound debridement & closure
For mandibular canines
48. Tunnel technique for deeply impacted canines
◦ The tunnel technique is a combined therapeutic approach that includes
both surgical exposure of the impacted canine and orthodontic traction
of the tooth to the center of the alveolar ridge, followed by final
orthodontic alignment
Indication
Persistence of the corresponding deciduous tooth
The presence of an adjacent lateral incisor with severe root resorption
49. Procedure
1. After the extraction of the deciduous tooth, a full-thickness flap raised to
expose cortical plate.
2. Cortical bone resected to expose crown of impacted canine.
3. Bone is drilled in the floor of the extraction socket to create an osseous
tunnel.
4. An anatomically contoured fine mesh is fixed to the centre of the cusp of
the impacted canine; wire chains passed through osseous tunnels for traction
5. The flap is sutured in its original position with the chain emerging from the
socket of the deciduous tooth through the osseous tunnel
50. Advantage
◦ A healthy periodontium at the completion of therapy is the
expected outcome
◦ Avoids the expense and inconvenience of prosthetic implants,
since the canines can substitute for the lateral incisors while the
first premolars take the place of the canines
51. Auto-transplantation of canine
◦ It is the movement of a permanent tooth from its ectopic position on to
the edentulous alveolar crest in the same patient.
◦ Auto-transplantation provides not only a biological replacement of tooth
which has potential to induce alveolar bone growth but also supports
proprioceptive function by maintaining a normal PDL.
◦ Auto-transplanted tooth has potential to erupt with neighboring teeth
during continued facial growth.
52. Procedure
◦ After flap elevation, osteotomy is performed using a round medium-size
bur (2-3 mm in diameter) at the area of the impacted tooth
◦ Atraumatic removal of donor tooth during operation is a prerequisite to
an optimal clinical result.
◦ In unfavorable canine inclination or ankylosis, tooth extraction and
subsequent auto-transplantation becomes impossible
53. ◦ Root canal treatment has to be performed after extraction of the donor tooth.
◦ For tooth placement, an infra occlusive position is preferred to avoid contact with its
antagonists at the occlusal plane.
◦ Tooth splinting can be done either using interdental sutures or by using an acrylic
splint or by splinting with a 26 gauge wire.
54. ◦ Orthodontic traction may begin after the end of the 4th post-surgical week (Czochrowska et al., 2002).
◦ Success of the tooth can be checked based on
a) Tooth mobility (grade II or grade III mobility)
b) Root resorption
◦ Success rate reported by Czochrowska et al. (2002) based on tooth mobility & root resorption ranged
from 79% to 90% during a 10-year period.
◦ Andersson et al. (1989) studied the rate of root resorption and found that it is increased at younger
ages.
◦ Bauss et al (2004) noted that the more extensive the surgical management for the auto-transplantation
of the impacted tooth (such as in the case of extensive alveolar resorption at the edentulous area), the
lower the long-term successful rate.
56. Complications
INTRAOPERATIVE COMPLICATIONS
During incision
◦ Incisive canal or greater palatine vessels may get damaged.
During bone removal
◦ Damage to the roots to the adjacent teeth
◦ Slippage of bur into soft tissue
◦ Fracture of the bone when using a chisel and mallet.
57. During elevation
◦ Fracture of adjoining bone
◦ Damage to nasal wall.
◦ Slippage of tooth into maxillary sinus
During debridement
◦ Damage to the maxillary sinus
59. Conclusion
Impacted canine is one of the common causes of seeking dental care. Its management requires an
appropriate approach for obtaining acceptable and adequate results. Several management options
are available. It is role of the clinician to thoroughly investigate patients with impacted canines both
clinically and radiologically, for the appropriate management technique.