The development of upper and lower canines or eye teeth begins at the age of 4 or 5 months, but eruption of the upper canines takes places between 11 and 13 years of age, and lower canines between the ages of 9 and 11.
What is an Included canine?
An included or retained tooth is a tooth that does not erupt in the mouth by the normal age of eruption, and furthermore has a completely formed root. The frequency of included maxillary canines ranges from 0.92% and 2.2% in the general population, being more frequent in women (1.17%) than in men (0.51%).
When the canines in the upper dental arch do not erupt by around age 12, we speak of a canine included in the palate, or, as many patients call them, “impacted eye teeth”. The baby canine remains in its place, and this often goes unnoticed by the patient until the baby tooth becomes loose or falls out in adulthood. Upper canines can also be included in vestibular position (on the facial side of the teeth); this type of included canine seems to be related to a lack of space and alterations in the eruption of other teeth.
Origin of the “included canine”
In most cases, there are genetic causes that are responsible for the problem. There is a high family predisposition; it is often associated with other dental anomalies (small teeth, agenesis or absence of lateral incisors that normally guide the eruption of the canine). Some theories relate it to their development. The upper canine is the tooth with the longest formation time, it is formed far away in a deep area, has a long path for eruption, and furthermore is the last to erupt in the dental arch. Other possible causes of an included canine are the absence of reabsorption of the baby canine’s root (which might also be the result of the included canine), alterations in the dental germ, premature closure of the root and dental crowding. It is more frequent in women than in men. There seems to be no clear relationship between the different causal theories and presentation of these teeth.
Other included teeth may also be found, and must be treated with the same philosophy. Try to place them in their position in the mouth, especially if they make a significant esthetic impact (e.g. a front incisor).
With an included tooth, a study with a dental CAT scan, “cone beam computed tomography” (CBCT), is essential in order to know exactly where the canine is located.
Otros artículos sobre caninos incluidos:
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