THE IMPACTED MAXILLARY CANINE - FURTHER OBSERVATIONS ON ETIOLOGY, RADIOGRAPHIC LOCALIZATION, PREVENTION INTERCEPTION OF IMPACTION, AND WHENTO SUSPECT IMPACTION/

Adjacent anomalous or missing maxillary lateral incisors have been imp licated in the aetiology of palatally displaced canines by not providi ng proper guidance to the canine during its eruption. However,a recent review of the literature suggests that the aetiology of palatally dis placed canines is genetic in origin. The aetiology of labially impacte d canines differs, being due to inadequate space. Vertex occlusal radi ographs have recommended for localization but have limitations, and a case is illustrated where this radiograph is deceptive; The prevention /interception of a palatally displaced canine by the extraction of the deciduous canine is best carried out as early as the displacement is detected, mostly soon after 10 years of age. Usually, prevention/inter ception will avoid the surgical and orthodontic treatment needed to:al ign a palatally impacted canine and may help prevent resorption of the adjacent incisor root. Suspicions that an impaction could occur or ha s occurred arise a) before the age of 10 years,if there is a familial history and/or the maxillary lateral incisors are anomalous or missing ; b) after the age of 10 years if there is asymmetry in palpation or a pronounced difference in eruption of canines between the left and rig ht, side; or, the canines cannot: be palpated and occlusal development is advanced; or, the lateral incisor is proclined and tipped distally ; and, on a panoramic radiograph of the late mixed dentition if the in cisal tip of the canine overlaps the root of the lateral incisor.