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Volume 1 Issue 2
September 2010
Prevalence of Impacted Maxillary Canines
Original Article
Prevalence of Impacted Maxillary Canines in Patients
Attending Out Patient Department of Sri Siddhartha Dental
College and Hospital of Sri Siddhartha University, Tumkur,
Karnataka.
Dr.Sridharan K1, Dr. Srinivasa H2, Dr. Sandeep Madhukar2, Dr. Shailesh
Sandbhor 3
1
Professor & Head, 2Senior Lecturer, 3Post Graduate student, Department of
Orthodontics, Sri Siddhartha Dental College, Sri Siddhartha University, Agalakote,
Tumkur, Karnataka, India 572 107.
Abstract:
The objective of the present study was to determine the prevalence of
impacted maxillary canine in patients visiting out patient department of Sri
Siddhartha dental college and hospital. This study comprises data from
14069 patients who attended the O.P.D. of Sri Siddhartha Dental College &
Hospital of the Sri Siddhartha University, Tumkur, Karnataka between Jan
2009 to Dec 2009. Patients were examined in order to detect the impacted
maxillary canines by intraoral examination, palpation, dental records and
followed by radiographs. It was found that the prevalence of canine
impaction was 2.6 % in males and 3.6 % in females suggesting that
prevalence of impacted maxillary canines is more in females than males and
it is statistically significant. The overall prevalence for maxillary impacted
canines was found to be 3 % which suggested that it is much higher than
previous studies. The results of this study were slightly different than other
studies, while the dissimilarities may be attributed to the sample selection,
method of the study and area of patient selection, which suggest racial and
genetic differences.
Keywords:
Impacted
canines,
prevalence,
Clark’s
radiography.
Journal of Dental Sciences & Research 1:2: Pages 109-117
109 Journal of Dental Sciences and Research
rule,
panoramic
Volume 1 Issue 2
September 2010
Prevalence of Impacted Maxillary Canines
retention
Introduction:
The eruption of permanent
or
deciduous
early
loss
canine,
(c)
of
the
abnormal
a
position of the tooth bud, (d) the
complex series of events, mostly
presence of an alveolar cleft, (e)
genetically
whereby
ankylosis, (f) cystic or neoplastic
eruptive movements of the tooth
formation, (g) dilaceration of the
germ
root, (h) iatrogenic origin and (i)
maxillary
canine
represents
based,
taking
place
predetermined
time
at
and
a
route
enable the maxillary canine to find
idiopathic
condition
with
no
apparent cause2,3,4.
The prevalence of impacted
its antagonist at a predetermined
occlusal plane1. Apart from the
maxillary
eruption process, the successful
populations and ethnic groups has
development of permanent canine
been
involves the synchronized forward
studies1,2,5,6.
and lateral growth of the maxilla.
impacted
As
so
been reported to vary between 0.2
complex, it is not surprising that
to 2%1-6. The present study was
problems may arise, which lead to
performed
complications
prevalence of impacted maxillary
the
eruption
process
is
including
tooth
canine
the
in
subject
The
canine
determine
retardation or failure of eruption2,3.
canine
Failure
outpatient
department
permanent maxillary canine is a
Siddhartha
dental
common dental anomaly. The most
hospital.
of
the
common
causes
impactions
are
eruption
of
for
canine
usually
localized
and are the result of any one, or
combination
of
the
following
factors: (a) tooth size-arch length
discrepancies,
(b)
in
several
prevalence
maxillary
to
of
different
patients
of
has
the
visiting
of
Sri
college
and
Materials and methods:
This study comprised data
from 14069 patients who attended
the O.P.D. of Sri Siddhartha Dental
College
prolonged
110 Journal of Dental Sciences and Research
&
Hospital
of
the
Sri
Volume 1 Issue 2
September 2010
Prevalence of Impacted Maxillary Canines
Siddhartha
University,
Tumkur,
Karnataka, between Jan 2009 to
breached,
radiographs
were
advised.
Dec 2009 out of which 7791 were
For
each
case
thorough
males and 6278 were females.
clinical examination was done by
Patients were examined in order to
conventional
detect
inspection and palpation to find out
the
impacted
maxillary
methods
canines by intraoral examination,
any
palpation,
bulge of canine, splaying of lateral
dental
records
and
followed by radiographs.
All
carefully
by
deciduous
canine,
incisors, lost space, crowding or
radiographs
examined
retained
like
a
were
fibrous
single
region.
tissue
overlying
Cases
canine
in
which
skilled dentist on a transparency
conventional examination methods
projector under constant lighting
revealed that the maxillary canine
conditions.6
was impacted and if the patient
prevented
A
from
tooth
that
erupting
was
by
a
physical barrier was defined as an
impacted
tooth
7
.
Taking
into
was
ready
for
the
orthodontic
treatment then radiographs were
advised
which
helped
in
account the mean eruption time,
determining the type of impaction
canines
i.e. palatal or labial and whether it
were
considered
as
impacted when they remained in
was favorable
the jaw minimum two years after
Radiographs
the respective mean age of tooth
periapical radiographs which follow
eruption. For the purpose of this
the Clark’s rule and panoramic
study the cases of age more than
radiographs or dental CT scans
15 years were considered and were
were
defined in groups according to the
canine is much less of a concern
gender.
Whenever
because it is almost 10 times less
criteria5,6
for
Ericson’s
palpation
was
such
advised6.
frequently
or non-favorable.
as
The
impacted9.
intraoral
mandibular
After
the
examination of the patient records,
111 Journal of Dental Sciences and Research
Volume 1 Issue 2
September 2010
Prevalence of Impacted Maxillary Canines
patients who exhibited one or more
males
of
suggesting
the
following
pathological
and
3.6
that
%
in
females
prevalence
of
situations were excluded from the
impacted maxillary canines is more
study:
in females than males and ‘p’ value
•
or
suggested that it is statistically
fracture of the jaw that might
significant, which is shown in table
have
normal
1 and fig 1. The prevalence for
permanent
maxillary impacted canines in all
Any
disease,
affected
growth
•
of
trauma
the
dentition.
the cases was found to be 3 %
Any hereditary diseases or
which suggest that it is much
syndromes such as Down’s
higher than previous studies.
syndrome
Discussion:
or
cleidocranial
The present data indicated
dysostosis.
and
that the prevalence of maxillary
analyzed using the SPSS statistical
canine impaction in cases visiting
package (version 12 software). The
to Sri Siddhartha Dental College
differences
groups
was more than those reported in
were tested using the Chi-square
other studies. Our data has shown
test, and Mann Whitney test.
that the prevalence of maxillary
Results:
canine impaction to be 3%, which
Data
was
gathered
between
the
Of the 14069 patients, 7791
is much higher than the range of
were males (55.38%) and 6278
0.2% to 2% reported in other
were females (44.62%); the mean
studies. The incidence of impacted
age was 24 ± 15.71 years, ranging
upper permanent canines within
from 15 to 62 years. A total of 195
the
impacted maxillary canines were
approximately 1.5 – 2 % with up to
found in 170 males and 221 were
85
in 168 females. The prevalence of
impactions2, 5.
general
%
canine impaction was 2.6 % in
112 Journal of Dental Sciences and Research
of
these
population
being
is
palatal
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September 2010
Prevalence of Impacted Maxillary Canines
Ericson
in
his
study
A
has
strong
prevalence
of
found that the rate of impacted
impacted canines is found among
maxillary canines was in the range
females, with a ratio of 2.3:1
of 0.9 - 2 %6. One more study by
the group of American patients,
Stewart
2.5:1
showed
that
the
2,3,10
2
in
in an Israeli orthodontic
prevalence of impacted canine was
group, and 3: 1 in both a Welsh
in the range of 1-3 %, and it was
orthodontic group2 and in a US
also
of
orthodontic sample2. Also it was
maxillary canines have 10 times
2.4:1 in Greek population as per
more
Anastasia Fardi’s observations and
found
that
impaction
prevalence
than
the
mandibular canines9.
In
any
population,
in the same study the impacted
the
canine prevalence was also found
increased1.
prevalence of impacted maxillary
to
be
However,
canines is low, but it seems to
random Israeli population study
have a variable distribution with
has shown an approximately equal
regard to ethnic origin. The lowest
male-female
frequency reported in the literature
anomaly11.
occurrence
of
a
the
To compare the prevalence
relates to the Japanese, where the
anomaly occurred in only 0.27% of
found
the sample population2. A study of
different frequencies reported in
a large series of full mouth dental
the dental literature from other
radiographs among patients in the
studied
USA revealed a figure of 0.92 %2.
consider the methodology used for
While Brin et al in a study of an
detection
Israeli population, found a level of
canines as
1.5 %2. The highest figure for the
differences of the epidemiological
anomaly found is 1.8%, which has
studies, including sample selection,
been reported in the study of an
definition of impacted tooth and
Icelandic population2.
the age range of subjects. It is not
113 Journal of Dental Sciences and Research
in
this
study
populations,
of
one
impacted
well
with
the
should
maxillary
as the
clinical
Volume 1 Issue 2
September 2010
Prevalence of Impacted Maxillary Canines
easy
to
choose
an
appropriate
attended
our
out
patient
sample to examine the frequency
department. The different results
of impacted teeth. To determine
from these studies may arise from
the
racial differences and differences in
actual
impaction,
prevalence
of
tooth
a representative
and
the
methodology
of
the
study.
randomized sample of the general
Because of the rarity of impacted
population
canines in the mandible, they were
Undoubtedly,
is
it
required.
is
not
straight
not
considered
in
this
forward to collect such information,
Indeed,
most
as exposing patients to radiation
canines
were
located
for research purposes conflicts with
maxilla,
which
had
medical ethics. The most common
established
practical approach is to examine
location by others.
radiographs
from
specific
The
of
as
the
the
early
study.
impacted
in
also
the
been
predominant
recognition
of
populations, which will inevitably
canine impaction is very important
involve the risk of bias in the data
from a therapeutic point of view.
analysis.
Impacted canines result in many
Taking
into
account
the
complications
and
their
early
source of the analyzed data, which
detection is imperative. The results
were derived from our study, the
of this study showed increased
large age range of the examined
prevalence of impacted maxillary
sample and the limited exclusion
canines than data reported in other
criteria, one might consider that
studies,
the results of this study are not
may be attributed to the sample
representative
general
selection, method of the study and
population. However, the primary
area of patient selection, which
aim of this study was to investigate
suggest
the
differences.
frequency
of
the
of
impacted
maxillary canines in patients who
114 Journal of Dental Sciences and Research
while
the
racial
dissimilarities
and
genetic
Volume 1 Issue 2
September 2010
Prevalence of Impacted Maxillary Canines
References :
Conclusion:
1. The prevalence of impacted
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impacted
in cases who attended the
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The
the Sri Siddhartha University,
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Becker
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Our data has shown that the
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dental
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canine impaction is very important
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while
the
examination
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Prevalence of Impacted Maxillary Canines
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116 Journal of Dental Sciences and Research
Eur
j
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September 2010
Prevalence of Impacted Maxillary Canines
3.6%
4.0%
3.0%
3.5%
2.6%
3.0%
2.5%
2.0%
1.5%
1.0%
0.5%
0.0%
Male
Female
Total
Fig. 1: Prevalence of Impacted Maxillary canines.
Table 1. Prevalence of impacted maxillary canines
No. of
months
12
Male
Female
Total
No.
Impacted
%
No.
Impacted
%
7791
195
2.5
6278
221
3.5
117 Journal of Dental Sciences and Research
‘p’
value
0.003
No.
Impacted
%
14069
416
3.0