Pacific Coast Society of Orthodontists Bulletin Spring 2014 - (Page 35)

SUMMARY ANNUAL SESSION The Interdisciplinary Team: Managing Patients with Impacted or Ectopically Positioned Teeth Presented by Dr. Douglas Knight and Dr. Jim Janakievski at the PCSO Annual Session, October 18, 2013. Summarized by Dr. Shahram Nabipour, PCSO Bulletin Central Region Editor D r. Janakievski is a periodontist; Dr. Knight is an orthodontist. They both practice in Tacoma, WA. They showed several cases of impactions and ectopically erupted teeth that they have treated together. Dr. Knight emphasized that in treating multidisciDr. Janakievski plinary cases, it is important to work with a surgeon who not only is skilled at treating impactions, but also is able to educate the orthodontist in terms of specific treatments and can communicate that clearly and effectively. A gentle nature also helps, especially when it comes to treating younger patients. litigation against orthodontists is the claim that they have not managed a patient periodontally. The second most common reason for litigation is impacted canines. In coordination with the surgeon, the orthodontist has to consider the proper surgical Dr. Knight technique (closed vs. open eruption), the proper mechanics, and the esthetic predictability of each method. DIAGNOSIS OF CANINE IMPACTIONS * There is a 1% to 2.5% occurrence rate in the population. Impacted canines are found in one of three positions: labial, mid-alveolar, or palatal. The position of the impacted canine can be determined using the object buccal rule on an anterior PA X-ray periapical radiograph. But a cone-beam computed tomography (CBCT) scan is a much more valuable tool in determining the relative position of the canine as well as its proximity to the roots of the adjacent teeth. * Canines are the second most commonly impacted teeth. PALATAL IMPACTIONS: OPEN OR CLOSED ERUPTION * Canine impactions are twice as common in girls as in boys. * Almost 1% of kids between the ages of 10 to 13 have root resorption of the incisors as the canine erupts. * 8% to 10% of all canine impactions are bilateral. * Palatal impactions are more common compared to labial impactions by a 2:1 ratio. Palatal impactions are the most common and can be treated by either open or closed eruption techniques. Before tackling the surgical technique, it's important to consider post-treatment esthetics on impacted canines. Would you be able to tell the difference between an impacted canine and the contralateral, non-impacted canine post-treatment? Symmetry, it turns out, has a lot to do with our view of dental esthetics, and as such, slight differences between an impacted canine and its contralateral counterpart can have a great impact on the esthetic outcome of the case. The following questions are important when comparing the impacted canine vs. the naturally erupted contralateral canine: Why is the topic of impactions important? Consider the following statistics: Considering the very low occurrence rate, then, why is this topic so important? The most common reason for SPRING 2014 * PCSO BULLETIN 35

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2014

A Magical, Spooky, International, Educational Time in Anaheim
New Columns
View From The Top: President’s Perspective
AAO Council on Scientific Affairs (COSA) Report
AAO Trustee Report
ABO Update
How To Save a PCSO Bulletin Article as a .PDF File
The Importance of Healing
Incoming and Outgoing Radiographs
Resident Spotlight: A.T. Still University, Arizona School of Dentistry & Oral Health Postgraduate Orthodontic Program
Use of the XBOW™ Appliance Vs. the FORSUS™ Appliance for Class II Correction
Advanced Research Avenues at the Roseman University of Health Sciences Orthodontic Program
Dr. Gerald Nelson
The Interdisciplinary Team: Managing Patients with Impacted or Ectopically Positioned Teeth
Miniplate Anchorage for Midface Protraction in Class III Patients and Molar Distalization in Class II Malocclusions
Achieving Financial Independence: A New and Younger Members Featured Lecture
The Role of Orthodontics in Trauma Management
Converting a Tube

Pacific Coast Society of Orthodontists Bulletin Spring 2014