Diagnosis and prevention of maxillary cuspid impaction

Early diagnoses and prevention of maxillary cuspid impactions can save much time when treating patients orthodontically. Effective recognition and interception requires initial diagnosis at the dental age of about eight years. When a cuspid bulge is absent, diagnosis with oriented lateral and frontal radiographs is advocated and has been shown to aid in the positive recognition of lingually positioned unerupted maxillary cuspids at risk for impaction. Recommended treatment is early removal of maxillary deciduous cuspids and perhaps deciduous first premolars. Lateral and frontal radiographs should be taken at six-month intervals to follow the intra-bony eruptive movement of the permanent cuspids until they have entered the oral cavity. Failure to diagnose and intercept the potentially impacted cuspid often leads to serious malpositions that require extensive mechanical therapy for proper alignment and good function.