In the case of upper canines, some professionals have suggested selective extraction of the temporary canine at the age of 8 or 9, in order to prevent inclusion of the permanent canine in cases without crowded teeth.
Authors Ericson and Kurol (1986) found that 91% of permanent upper canines with improperly directed eruption corrected their position when the temporary tooth was extracted before age 11. However, the success percentage with this procedure decreased to 64% if the canine crown went beyond the midline of the lateral incisor.
A drawing that relates the position of the included canine to its probability of erupting unaided, once the baby canine is extracted.
Generally, at age 8 or 9 one can palpate a protrusion of the canine crown in the high part of the gum (at the back of the vestibule). However, if this protrusion does not exist at age 10, it does not necessarily mean that the canine will have a problem erupting; often, between the ages of 8 and 10, the direction of eruption corrects itself spontaneously.
At our clinic, we always do an orthopantomography at this age (8-9) and we check for any alteration in the eruption of the canine, looking for an overlap over the lateral incisor, or any damage to its root.
Although the orthopantomography done at age 10 or 11 is a good method for early detection of an included canine, it is not infallible; about 20% of cases are not discovered.
A more reliable sign, which can be detected early on in panoramic X-rays of individuals suspected for impacted maxillary canine, is the degree of development of the neighboring lateral incisor. Canine overlap over the lateral incisor suggests a poor prognosis when, at age 11 or older, the root of the lateral incisor is fully developed.
There are situations that tend toward inclusion of the upper canine, such as lack of space and agenesis of lateral incisors.
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