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

Abstract

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.

Keywords

treatment difficulty index - impacted maxillary canines - treatment prognosis - human and health

Publication History

Article published online:
11 January 2022

• References

• 1 Ajami S, Shahidi S, Azadeh N, Nasr Jalali H, Zare M. Difficulty of palatal impacted canine treatment in different sagittal and vertical skeletal malocclusions: a retrospective 3D evaluation. Int Orthod 2020; 18 (01) 89-95
• 2 Dalessandri D, Migliorati M, Visconti L, Contardo L, Kau CH, Martin C. KPG index versus OPG measurements: a comparison between 3D and 2D methods in predicting treatment duration and difficulty level for patients with impacted maxillary canines. BioMed Res Int 2014; 2014: 537620
• 3 Sunil G, Ranganayakulu I, Ram RSVMR. Maxillary canine impaction - A hitch in orthodontic treatment planning. IAIM 2018; 5 (06) 72-76
• 4 Kinaia BM, Agarwal K, Bushong B. et al. Surgical management of impacted canines: a literature review and case presentations. J Dent Oral Biol 2016; 1 (03) 1012
• 5 Pico CL, do Vale FJ, Caramelo FJ, Corte-Real A, Pereira SM. Comparative analysis of impacted upper canines: panoramic radiograph Vs Cone Beam Computed Tomography. J Clin Exp Dent 2017; 9 (10) e1176-e1182
• 6 Shin H, Park M, Chae JM, Lee J, Lim HJ, Kim BC. Factors affecting forced eruption duration of impacted and labially displaced canines. Am J Orthod Dentofacial Orthop 2019; 156 (06) 808-817
• 7 Becker A, Chaushu S. Surgical treatment of impacted canines: what the orthodontist would like the surgeon to know. Oral Maxillofac Surg Clin North Am 2015; 27 (03) 449-458
• 8 Cruz RM. Orthodontic traction of impacted canines: concepts and clinical application. Dental Press J Orthod 2019; 24 (01) 74-87
• 9 Sajnani AK, King NM. Retrospective audit of management techniques for treating impacted maxillary canines in children and adolescents over a 27-year period. J Oral Maxillofac Surg 2011; 69 (10) 2494-2499
• 10 Alqerban A, Hedesiu M, Baciut M. et al; SedentexCT Consortium. Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging. Dentomaxillofac Radiol 2013; 42 (09) 20130157
• 11 Sajnani AK, King NM. Early prediction of maxillary canine impaction from panoramic radiographs. Am J Orthod Dentofacial Orthop 2012; 142 (01) 45-51
• 12 Alqerban A, Jacobs R, Fieuws S, Willems G. Radiographic predictors for maxillary canine impaction. Am J Orthod Dentofacial Orthop 2015; 147 (03) 345-354
• 13 Arriola-Guillén LE, Aliaga-Del Castillo A, Ruíz-Mora GA, Rodríguez-Cárdenas YA, Dias-Da Silveira HL. Influence of maxillary canine impaction characteristics and factors associated with orthodontic treatment on the duration of active orthodontic traction. Am J Orthod Dentofacial Orthop 2019; 156 (03) 391-400
• 14 Pitt S, Hamdan A, Rock P. A treatment difficulty index for unerupted maxillary canines. Eur J Orthod 2006; 28 (02) 141-144
• 15 Counihan K, Al-Awadhi EA, Butler J. Guidelines for the assessment of the impacted maxillary canine. Dent Update 2013; 40 (09) 770-772 , 775–777
• 16 Diop Ba K, Diouf JS, Badiane A, Ngom PI, Diagne F. Orthopantomographic analysis of the intraosseus position of the maxillary canines. Int Orthod 2019; 17 (02) 324-332
• 17 Iancu Potrubacz M, Chimenti C, Marchione L, Tepedino M. Retrospective evaluation of treatment time and efficiency of a predictable cantilever system for orthodontic extrusion of impacted maxillary canines. Am J Orthod Dentofacial Orthop 2018; 154 (01) 55-64
• 18 Katiyar R, Tandon P, Singh GP, Agrawal A, Chaturvedi TP. Management of impacted all canines with surgical exposure and alignment by orthodontic treatment. Contemp Clin Dent 2013; 4 (03) 371-373
• 19 Sharma A, Jain U, Kallury A, Chhajed R. Management of impacted maxillary canines using the Kilroy spring: a case series. J Indian Orthod Soc 2016; 50: 177-183
• 20 Grybienė V, Juozėnaitė D, Kubiliūtė K. Diagnostic methods and treatment strategies of impacted maxillary canines: A literature review. Stomatologija 2019; 21 (01) 3-12
• 21 Al-Abdallah M, AlHadidi A, Hammad M, Dar-Odeh N. What factors affect the severity of permanent tooth impaction?. BMC Oral Health 2018; 18 (01) 184
• 22 Koutzoglou SI, Kostaki A. Effect of surgical exposure technique, age, and grade of impaction on ankylosis of an impacted canine, and the effect of rapid palatal expansion on eruption: A prospective clinical study. Am J Orthod Dentofacial Orthop 2013; 143 (03) 342-352
• 23 Alhammadi MS, Asiri HA, Almashraqi AA. Incidence, severity and orthodontic treatment difficulty index of impacted canines in Saudi population. J Clin Exp Dent 2018; 10 (04) e327-e334
• 24 Biswas N, Biswas SH, Shahi AK. Maxillary impacted canine: diagnosis and contemporary ortho surgical management guidelines. International Journal of Scientific Study 2016; 3 (10) 166-170
• 25 Brinkmann JC, Lobato-Peña M, Pérez-González F. et al. Placing dental implants through impacted teeth to support a fixed partial denture in a geriatric patient as an alternative to invasive extraction surgeries. Eur J Dent 2020; 14 (04) 697-701
• 26 Narmada IB, Putri PD, Lucynda L, Triwardhani A, Ardani IGAW, Nugraha AP. Effect of caffeic acid phenethyl ester provision on fibroblast growth factor-2, matrix metalloproteinase-9 expression, osteoclast and osteoblast numbers during experimental tooth movement in wistar rats (Rattus norvegicus). Eur J Dent 2021; 15 (02) 295-301