Yerucham Zilberman

Root length of lateral incisors adjacent to palatally-displaced maxillary cuspids.

An evaluation of 70 palatally-displaced cuspids and 106 controls finds significantly shorter lateral incisor adjacent to the palatal cuspids.

Periodontal status following the alignment of palatally impacted canine teeth

Twenty-three patients who had completed treatment to resolve the unilateral palatal impaction of a maxillary canine by orthodontic means were examined 2.3 years (mean) after all appliances had been discarded. Scores were noted for the plaque index, gingival index, attached gingiva, pocket depth, and bone support on each of the affected teeth and also on the contralateral canine which had been unaffected and thus acted as a control. In addition, the teeth immediately adjacent to both canines were similarly scored. The results indicated no significant difference in the plaque index and the amount of attached gingiva, while the gingival index, pocket depth, and particularly the bone support all showed statistically valid differences. It is suggested that in these cases a postorthodontic assessment of the state of the supporting tissues be performed and periodontal treatment instituted in those requiring it.

Resorbed lateral incisors adjacent to impacted canines have normal crown size

The importance of detecting maxillary canine impaction is that it may compromise dental health, particularly since a small but significant proportion of impacted canines is associated with the resorption of the roots of neighboring teeth. It has been shown that the existence of small and peg-shaped lateral incisors is highly correlated with maxillary canine palatal impaction. To date, however, it has not been established whether the root resorption that occurs has a similar correlation or a predilection for one or other types of lateral incisor crown structure. Accordingly, a group of patients with buccally or palatally impacted canines, in which root resorption of the lateral incisor could be diagnosed roentgenographically, was examined and compared with a group of cases with palatally impacted canines, none of which showed root resorption, which served as controls. The mesiodistal crown dimension of the lateral incisor in the experimental group was found to be normal in all patients except three (13%), which was significantly different from the distribution of lateral incisor size in the control group (p < 0.001). In the majority of the cases, aggressive root resorption of the lateral incisor root had occurred. We would speculate that in these cases, the normal-sized and early developing lateral incisor root obstructs the deviated eruption path of the canine and consequently stands a considerably greater chance of being damaged by resorption.

Trauma as a possible etiologic factor in maxillary canine impaction

A chain of events in the development of the dentition following trauma is described. Shortening of the root of the lateral incisor or displacement of the tooth bud, both as a sequel to trauma, may affect the path of eruption of the adjacent canine after dental injury. Special attention should be paid to the further development and eruption of the directly and indirectly affected teeth.

Maxillary incisor impaction and its relationship to canine displacement

This study aimed to examine the eruption status of unerupted maxillary permanent canines in patients who also had an impacted central incisor. Seventy-five unilateral cases of the incisor anomaly were retrospectively examined. Using the initial panoramic films, we assessed the positions of the ipsilateral and contralateral canines and the lateral incisors and the timing (eruption progress) of the canines. The final position of the canines was evaluated from patient records and progress photographs. The data showed a significant increase in prevalence and severity of displaced canines in the ipsilateral side (41.3%) compared with the contralateral side (4.7%). Palatally displaced canines occurred in 9.5%, buccally displaced canines in 30.2%, and canine-lateral incisor transposition in 1.6% of the patients. Half of the buccally displaced canines in the ipsilateral side were pseudotransposed with the adjacent lateral incisor. The eruption timing of ipsilateral undisplaced canines was either similar or delayed, relative to the contralateral tooth, but never accelerated. The ipsilateral lateral incisor was strongly angulated because of a more distally located apex (5 mm) rather than a mesially tipped crown. The ipsilateral canine was relatively more superiorly positioned (undererupted). Patients who had trauma had a significantly higher prevalence and severity of canine displacement and more distally displaced lateral incisor apices. Initial height of incisor impaction did not influence the results. These data provide evidence of a significant environmental influence of an impacted maxillary central incisor in delaying and altering the eruption path of the ipsilateral maxillary canine.

Periodontal status following the alignment of buccally ectopic maxillary canine teeth

Twenty-nine patients who had completed orthodontic treatment to resolve buccal displacement of maxillary canine teeth were examined 2.9 years (mean) after all appliances had been discarded. Thirteen of these patients had unilateral displacement, and sixteen were bilaterally affected. In the unilateral cases only the width of attached gingiva was significantly less than in the controls. In the bilateral cases the same observation was made, but here the gingival index and pocket depth also showed statistically significant increases, although the expression of these values was found to have doubtful clinical significance. Posttreatment periodontal assessment is recommended for these cases.

The palatally impacted canine: a new approach to treatment.

A method for the application of traction to misplaced maxillary canines in the palate is described. The treatment approach is from the palatal side, with initial traction applied in a lingually downward direction to prevent interference with the neighboring teeth. Emphasis is placed on the suitability of the method as an adjunct to almost any of the established techniques. In this way improving their efficiency in treating the over-all orthodontic problem.

Clinical and roentgenographic evaluation of thirty-seven autotransplanted impacted maxillary canines

Thirty-seven autotransplanted canines in thirty-one patients were observed for a period of 2 to 7 years. Transplants with less than 2 years follow-up were not included in this study. Although the surgical root canal, and fixation techniques were identical, the delayed pathophysiologic changes were different.

Estimation of Mesiodistal Width of Permanent Canines and Premolars in Early Mixed Dentition

The accuracy for predicting mesiodistal widths of unerupted permanent canines and Premolars from x-rays and their estimations based on the already erupted permanent teeth were tested in a group of Israeli children. The observed posteruptive widths related more closely to predicted values obtained from x-ray measurements than from tabulated estimations.

Eruption of rootless teeth in congenital renal disease

Eruption of rootless mandibular premolars and other dental defects in a girl suffering from congenital kidney disease are described. The successful management of these excessively mobile teeth allowed them to develop roots of sufficient length. Hypotheses of tooth emergence are viewed in the light of these rootless eruptions.