Clinical Assessment & Presentations
Intraoral Features
Labial canine bulge
If a palpable labial canine bulge is not present by age 10, ectopic canines should be investigated with radiographs (Ferguson 1990). The canine bulge is present superior to the C’s position and should be easily palpable or even visible clinically on normal examination.
Diminutive or displaced lateral incisors
Small or developmentally absent lateral incisors are associated with ectopic canines as the distal aspect of the lateral incisor roots provide guidance for the erupting canines (Becker 1995). Displace lateral incisors due to crowding can also lead to the lack of guidance and ectopic canine development (Hudson et al. 2011).
Radiographic signs
A panoramic radiograph should be taken by age 9 to assess the canines’ eruption path, the development of the adjacent teeth and any obstructions present.
Upper ectopic canines have been divided into different sectors and angulations to categorise their severity and preferred modalities of treatment.
Ericison and Kurol defined 5 sectors of upper canine ectopia. The higher the sector the more severe the impaction.
The angulation of the canine (alpha angle) and distal to the occlusal plane (d) are also measures of severity. The impaction increases as angle and the distance from the occlusal plane increases.
Mandibular canine ectopia are rarer and not as well classified into sectors as the maxillary canines. Their positions can be seen on a panoramic radiograph and if their ectopia are detected early, interceptive treatment can be provided.
