Indications for extraction of permanent maxillary canines – a literature review

Orthodontic movement of a maxillary canine into the dental

arch may be a therapeutic challenge, and it is necessary to

analyse a case in detail and to evaluate therapeutic methods,

including a difficult decision of tooth extraction in all cases.

Aim. The paper aims to discuss orthodontic indications for

maxillary canine extraction based on available literature.

Material and methods. The PubMed database and the

following key words were used for studies: canine impaction,

maxillary impacted canine and canine extraction. Literature

was supplemented with publications from reviewed journals

not included in the PubMed database. 50 papers were selected

from the literature list. Results, review and discussion.

A decision to extract a maxillary canine should be made

based on a detailed clinical examination and analysis of

orthodontic records, including photographs, diagnostic

models and radiological scans. CBCT imaging test should be

performed as standard before treatment in case of impaired

tooth eruption. Factors that should be especially considered

include: tooth anatomy, periodontal status, position in the bone, occlusion, condition of the adjacent teeth and any

pathological processes in the tooth vicinity. Before making

a therapeutic decision a patient should be informed about

available therapeutic options according to current medical

knowledge, as well as about advantages and disadvantages

of each of them. Summary. Factors favouring extraction of

impacted canines or canines with impaired eruption include:

unfavourable position (a horizontal position of a tooth in

the bone, position in the zone IV and V according to Kurol,

large distance from the edge of the alveolar process),

anatomical abnormality (root angulation, external or internal

resorption), root ankylosis, patient’s age above 30 years and

good occlusion without a canine in the dental arch with the

need to extract a premolar for its movement into the dental

arch. (Baszak J, Sobieszczańska A, Dunin-Wilczyńska I.

Indications for extraction of permanent maxillary canines

– a literature review. Orthod Forum 2018; 14: 130-42).