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Rank: Member
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Joined: 8/25/2008
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Ericson and Kurol have advocated the early extraction of deciduous canines when permanent canines are ectopically erupting. The chance of permanent canines normalizing on it's own without any further intervention ranges between 60-90% they stated. Others advocates leaving the deciduous teeth to shed normally on it's own. Where the wisdom lies??
Lama Jarrah
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Joined: 5/14/2006
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Hullo,
I do not know exactly what Ericson and Kurol stated and the full context. However, over years of experience seeing large number of retained deciduous canines and unerupted/ectopic permanent canines, we face a particular problem with the extraction of deciduous canines. Previously we used to extract explaining to the parents that the erupting canine would take path of least resistance, into the extracted space(?vacuum suction effect).
The parents become impatient to wait for eruption of the permanent canine. At times, when eruption does not happen, anxiety becomes comaplaint. 'The doctor extracted the well standing tooth expecting/promising proper eruption of permanent tooth- Wrong judgement?' In the contemporary 'defensive medical/dental practice' era and litigations under consumer protection act prevailing, I am afraid, we have a weak defense. There is also shift in view to extract severely malposed canines and replace it rather than saving it at whatever cost/Herodontics!
Jayaram Mailankody, Calicut, India.
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Early treatment of ectopic maxillary canines is called for because of the risk of maxillary incisor root resorption .(1,2) Resorption might occur on nearly 50% of adjacent incisor roots(3,4). In a prospective clinical trial by Ericson and Kurol (5), early extraction of deciduous canines was performed in young people, 10 to 13 years of age. Radiographic and clinical examinations were made after 6, 12, and 18 months. Seventy-eight percent of the palatally positioned ectopic canines normalized thus reducing the need for orthodontic appliances. In light of these studies detecting an ectopically erupting canine and not initiate interceptive treatment could have a legal liability. Explaining the objectives and length of the interceptive treatment initiated to parents relieves to great extent any impatience. Parents will cooperate fully when the advantages of the treatment is clarified.
Lama Jarrah
1. Ericson S, Kurol J. Incisor resorption caused by maxillary cuspids: a radiographic study. Angle Orthod. 1987;57:332–346.
2. Ericson S, Kurol J. Resorption of maxillary lateral incisors caused by ectopic eruption of the canines: a clinical and radiographical analysis of predisposing factors. Am J Orthod Dentofacial Orthop. 1988;94:503–513.
3. Ericson S, Kurol J. Incisor root resorptions due to ectopic maxillary canines imaged by computerized tomography: a comparative study in extracted teeth. Angle Orthod. 2000;70:276–283.
4.Ericson S, Kurol J. Resorption of incisors after ectopic eruption of maxillary canines: a CT study. Angle Orthod. 2000;70:415–423.
5.Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of primary canines. Eur J Orthod. 1988;10:283–295
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