Presentations 2020: Ortho&Paeds

436 - Ectopic Maxillary Canines, the Consequences of Late Referral

H Bradley L Hirst M Collard
Presented by: Hannah Bradley
Cardiff Dental Hospital

Introduction Ectopic maxillary canines are a frequently encountered deviation from normal development with a prevalence of around 1.5%. National guidance from the Royal College of Surgeons states palpation of the buccal sulcus for the maxillary canine should commence from age 8. Incisor root resorption induced by ectopic maxillary canines is a relatively frequent complication, particularly when diagnosed late. Case description We present the case of a patient with a hopeless prognosis severely resorbed lateral incisor following the late diagnosis of an ectopic maxillary canine. They initially presented at age 15 with a palatally ectopic 23. Periapical radiographs and a Cone-Beam Computed Tomograph revealed direct contact between the ectopic canine and the roots of the 21 and 22. At this stage, significant resorption of these roots with pulpal exposure and bone loss was already apparent. The patient underwent extraction of the 63, open exposure of the 23 and fixed appliance therapy was used with a treatment time of 2 years and 2 months. At the age of 20, the patient attended our emergency dental department with a dental abscess associated with the 22. A periapical revealed severe root resorption with a well-defined apical radiolucency and subsequent hopeless prognosis. Conclusion This case highlights the potential catastrophic complications of ectopic canines, especially when presenting late. These complications require complex multidisciplinary treatment and life-long maintenance which can be distressing and time consuming for patients. We remind practitioners the importance of early diagnosis and timely management to reduce the risk of incisor root resorption. Managing patient expectations and good record keeping are also paramount when dealing with such complications.
Consent Statement: Written informed consent for publication of their clinical details and/or clinical images was obtained from the patient/parent/guardian. A copy of the consent form is available for review by the the meeting organisers..

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