Description
Ectopic canine
“An ectopic canine is a canine which has deviated from its normal path of eruption. It may present as an erupted or unerupted tooth; on the palatal/lingual, mid-arch or buccal surfaces; and on the maxilla or mandible.”
– Proffit et al. 2013, Hudson et al. 2011
Maxillary palatally ectopic canine
Maxillary buccally ectopic canine
Maxillary midalveolar impacted canine
Mandibular lingually ectopic canine
Mandibular buccally ectopic canine
Mandibular midalveolar ectopic canine
Canines are the second most commonly impacted teeth after third molars (Proffit et al. 2013). Upper canines are more likely to be ectopic than lower canines (Cobourne and DiBiase 2010). The two most common presentations are upper palatally ectopic and upper buccally ectopic canines (Ericson and Kurol 1978). Upper palatally ectopic canines occurs in 1-2% of caucasian populations (Aydin et al. 2004, Shah et al. 1978) and they can cause significant resorption/damage to adjacent teeth if they are left unchecked (Proffit et al. 2013). Upper buccally ectopic canines occur mostly as a result of arch length loss (i.e. crowding) (Becker 2015) and they can be abrasive to the upper lip and often a significant aesthetic issue for the patient.
Mandibular canines ectopia normally present as vertically positioned, however it may be transposed with adjacent teeth or in severe cases it may even migrate to the other half of the mandible whilst horizontally orientated.
Unilateral canine ectopia happens more frequently than bilateral ectopia by 4:1 and females have twice the incidence of canine ectopia than males (Mossey et al. 1994). Adjacent roots can be impacted and damaged by resorption due to the canine ectopia. Early diagnosis and interceptive treatment is key in their management (Ericson and Kurol 1987).
Treatment options for ectopic canines revolve around interceptive treatment for spontaneous eruption, exposure of the canines and active orthodontic traction, extraction of the canines and management of the occlusion and leaving the canine in-situ (Cobourne and DiBiase 2010). The treatment options will depend on patient and clinician concerns as well as the malocclusion and severity of the canine ectopia. Usually very severe canine ectopia may warrant extraction and mild ectopia may self-correct with interceptive treatment.
Early identification of canine ectopia (by the age of 10 to 11 for uppers and 9-10 for lowers) will allow the patient a chance of interceptive treatment with a specialist orthodontist or dentist.
