The Impacted Maxillary Canine in the Adult: A Narrative Review and Implant Treatment Options

The purpose of this article is to provide clinicians with options to restore the adult patient with an impacted maxillary canine using dental implants. Literature was reviewed to provide evidence for the methods suggested.

The search strategy utilized pubmed.gov to identify articles pertinent to identified treatment options. The search used terms which included dental implants and impacted tooth, tilted implants and fixed partial prostheses, 6 mm dental implants, and 4 mm dental implants. Articles were included if they reported dental implant procedures associated with impacted canines in adults, or if they reported on the use of tilted implants, immediate implant placement at time of canine removal, or the use of short implants. Articles with less than 12 months follow up were excluded.

The search identified articles which included dental implants and impacted tooth (n = 142), tilted implants and fixed partial (n = 36), 6 mm dental implants (n = 182), and 4 mm dental implants (n = 162). From this search, 28 articles were collated that satisfied the inclusion criteria. The use of tilted implants had success rates ranging from 93% to 99%. Short implants had success rates ranging from 87 to 90% in the posterior maxilla. Immediate implant placement after removal of the impacted canine lacked long term reports. Two cases are included to demonstrate treatment planning using navigation to guide implant placement in an adult patient with an impacted maxillary canine.

The evidence-based literature concerning implant placement associated with adult maxillary canines is limited. There is evidence to support tilting implants to avoid the impacted canine, or the use of short implants splinted together to avoid the impacted tooth. Other options had insufficient data to offer support.