Prevalence and Pattern of Canine Impaction and Its Associated Anomalies among Orthodontic Patients Attending Tertiary Care Dental Hospital in Kathmandu

Abstract

Introduction: Permanent canines are considered as the cornerstone of mouth. Canines are important for esthetics and function as they are located in the anterior segment of the mouth and help in tearing of food. An impacted tooth is that tooth that cannot or will not erupt into its normal functional occlusion due to some circumstances. Those impacted tooth are considered pathologic as they might lead to various problems like resorption of roots of adjacent teeth, cystic formation, and infection with partial eruption leading to pain and trismus.
 Materials & Method: All the patients (550) being treated in department of Orthodontics in Nepal Medical College from January 2017 to December 2019 were included in the study. Patients aged 13-30 years were included in the study. Clinical examinations and panoramic radiographs of patients were taken. Anterior occlusal view was done in those patients having canine impaction to determine the patterns of impaction. Data was processed in SPSS version 16.0.
 Result: Among 550 orthodontic patients, 31 patients were found to have canine impaction. Among them 18 (58.1%) were females and 13 (41.9%) were males. The overall prevalence of canine impaction was found to be 5.6%. Various dental anomalies were observed in the participants’ radiographs, the most common being the retained deciduous teeth (54.8%) followed by dilacerations of adjacent teeth (51.6%). Peg shaped lateral incisors and root resorption of adjacent tooth were almost equal (22.6%) with least being the odontomas and other impacted teeth.
 Conclusion: The prevalence of canine impaction in tertiary care dental hospital in Kathmandu was found to be 5.6%. Patients with impacted canines also had other dental anomalies. Knowing the prevalence of impacted canines, will encourage the community to be aware about canine impaction and educate the population about the clinical implications and the importance of performing preventive and interceptive procedures.

Prevalence of maxillary canine impaction in an Egyptian population: a retrospective study

“…An investigation of 580 Bangladeshi radiographic records found that only 7 (1.2%) radiographs had impacted maxillary canines. 19 Piya et al 20 estimated that for all the 550 patients treated in Kathmandu's tertiary care dental hospital, the canine impaction prevalence was 5.6%. Volume 59 -June 2021 ISSN: 1110.435X Melha et al 21 assessed canine tooth impaction among the population of Riyadh in Saudi Arabia, analysed 2157 patients' panoramic radiographs and found canine impaction in 79 patients (3.65%).…”

Impacted Canines Classification Systems Among Orthodontic Patients

“…Following that, it migrates downwards and forward to lie mesial and buccal to the apex of the deciduous canine, then progresses downwards along the distal half of the upper lateral incisor's root. 20 According to Piya et al, 6 before the crown of the tooth, is calcified, the canine remains high in the maxilla, often above the root of the lateral incisor. It subsequently erupts over the distal surface of the lateral incisor, closing any physiological diastema that may exist as the canine erupts into position.…”

“…This is referred to as the ugly duckling stage. 6 Maxillary canines often arise between 11 and 12 years. 12 The mandibular canines begin to calcify at the age of four months, and the enamel of the crown is fully grown by the age of seven years.…”

“…Along with its root volume and length, it is one of the most important outstanding abutments for prosthetic replacement of other maxillary teeth. 6 Consequently, impacted canines pose numerous challenges for clinicians since it compromises tooth exposure as well as its movement for esthetical and functional outcomes. Displacement and non-eruption are critical consequences of ectopic eruption and impaction in these teeth with significant functional and cosmetic significance.…”

“…The cumulative score is used to predict the treatment's difficulty. Every impaction was graded into four levels: easy (0-7), moderate (8)(9)(10)(11)(12)(13)(14), difficult (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), and extremely difficult (20+). Four canines were graded as easy, eleven as moderate, nine as difficult, and four as extremely difficult.…”