Space conditions and dental and occlusal features in patients with palatally impacted maxillary canines: an aetiological study

The aetiology of palatal canine impaction is unclear. The aim of this research was to investigate the occlusal features that could contribute to the aetiology of palatal maxillary canine impaction. The material consisted of the pre-treatment dental casts of 34 patients (27 female and seven male) with unilateral palatal canine impaction (impaction group). The average age of this group was 17.7 years (+/- 4.6). These were matched according to age, gender and type of malocclusion with a comparison group of pre-treatment dental casts from unaffected orthodontic patients. From the dental casts the following parameters were obtained: (1) dentoalveolar arch relationship, (2) missing or anomalous teeth, (3) the mesiodistal width of each maxillary tooth, (4) the upper arch perimeter, (5) the maxillary inter-premolar and inter-molar widths. The arch length-tooth size discrepancy was only calculated for subjects with no missing teeth. Palatal canine impaction occurred most frequently in subjects with a Class II division 2 malocclusion. There was an association between palatal canine impaction and anomalous lateral incisors (P = 0.01). The transverse arch dimension was significantly wider in the impaction group than in the comparison group (P < 0.01). There was no statistically significant difference in the mesiodistal width of maxillary teeth or in the arch length-tooth size discrepancy between the palatal canine impaction group and their matched comparisons (P > 0.05). These results suggest that the presence of an 'excess palatal width' and anomalous lateral incisor may contribute to the aetiology of palatal canine impaction.