Impacted canines. A review of modern literature.

  • Víctor Alexander Cruz Gallegos Universidad Católica de Cuenca – Ecuador
  • Lorenzo Puebla Ramos Universidad Católica de Cuenca – Ecuador
Keywords: impacted tooth; canine; orthodontics, corrective; traction


The impaction of a dental organ is one of the most statistically common reasons in daily practice and its orthodontic resolution continues to be a challenge for the Specialist, where a canine is in second place among the most frequently impacted teeth with an incidence that ranges between 0.8% and 2.1%, with a ratio of 3:1 for palatal and vestibular impaction and with a frequency 2 times higher in women than in men. A search was carried out in various digital databases such as: Pubmed, SciencieDirect, Google Scholar, Scopus, Lilacs, Cochrane Library, Web of Science, Epistemonikos, Sage, ProQuest, and was restricted to articles published from 2018 to 2023 without language limit. The PRISMA checklist was applied, with which 30 articles suitable for this review were obtained and reviewed. Finally, the available literature reveals that an accurate diagnosis, careful localization of the impacted canine, correct choice of surgical approach, stable and reliable fixation of the orthodontic accessory, correct direction and magnitude of the applied force and conservative management of soft tissues lead directly to treatment success


Download data is not yet available.


Metrics Loading ...

Author Biographies

Víctor Alexander Cruz Gallegos, Universidad Católica de Cuenca – Ecuador

Odontólogo General de la Universidad UTE del Ecuador año 2017, Especialista en Ortodoncia de la Universidad Católica de Cuenca, en curso. Odontólogo Ministerio de Salud Pública del Ecuador año 2018 y 2019.

Lorenzo Puebla Ramos, Universidad Católica de Cuenca – Ecuador

Odontólogo General de la Universidad Nacional Autónoma de México, Especialista en Ortodoncia del Hospital Infantil de México Federico Gómez, Profesor de la Especialidad en Ortodoncia de la Secretaría de la Defensa Nacional de México (SEDENA)-México, Profesor Invitado de la Especialidad en Ortodoncia de la Unidad Académica de Posgrado de la Universidad Católica de Cuenca-Ecuador. Miembro de la Asociación Latinoamericana de Ortodoncia y Miembro de la Federación Mundial de Ortodoncistas.


Ahmed, A., Fida, M., & Sukhia, R.H. (2021). Cephalometric predictors for optimal soft tissue profile outcome in adult Asian class I subjects treated via extraction and non-extraction. A retrospective study. International Orthodontics, 19(4), 641–651.

Albagieh, H., Alomran, I., Binakresh, A., Alhatarisha, N., Almeteb, M., Khalaf, Y., Alqublan, A., & Alqahatany, M. (2023). Occlusal splints-types and effectiveness in temporomandibular disorder management. Saudi Dental Journal, 35(1), 70–79.

Alessandri Bonetti, G., Zanarini, M., Incerti Parenti, S., Marini, I., & Gatto, M.R. (2011a). Preventive treatment of ectopically erupting maxillary permanent canines by extraction of deciduous canines and first molars: A randomized clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics, 139(3), 316–323.

Alessandri Bonetti, G., Zanarini, M., Incerti Parenti, S., Marini, I., & Gatto, M.R. (2011b). Preventive treatment of ectopically erupting maxillary permanent canines by extraction of deciduous canines and first molars: A randomized clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics, 139(3), 316–323.

Alqerban, A., Willems, G., Bernaerts, C., Vangastel, J., Politis, C., & Jacobs, R. (2014). Orthodontic treatment planning for impacted maxillary canines using conventional records versus 3D CBCT. European Journal of Orthodontics, 36(6), 698–707.

Andreasen, G.F. (1971). A review of the approaches to treatment of impacted maxillary cuspids. Oral Surgery, Oral Medicine, Oral Pathology, 31(4), 479–484.

Ariji, Y., & Ariji, E. (2017). Magnetic resonance and sonographic imagings of masticatory muscle myalgia in temporomandibular disorder patients. Japanese Dental Science Review, 53, 11–17.

Baad-Hansen, L., Thymi, M., Lobbezoo, F., & Svensson, P. (2019). To what extent is bruxism associated with musculoskeletal signs and symptoms? A systematic review. Journal of Oral Rehabilitation, 46(9), 845–861.

Bae, S.S., & Aronovich, S. (2018). Trauma to the Pediatric Temporomandibular Joint. Oral and Maxillofacial Surgery Clinics, 30(1), 47–60.

Becker, A., & Chaushu, S. (2015). Surgical Treatment of Impacted Canines: What the Orthodontist Would Like the Surgeon to Know. Oral and Maxillofacial Surgery Clinics of North America, 27(3), 449–458.

Bedoya, M.M., & Park, J.H. (2009). A review of the diagnosis and management of impacted maxillary canines. Journal of the American Dental Association, 140(12), 1485–1493.

Bishara, S. E., Kommer, D. D., McNeil, M. H., Montagano, L. N., Oesterle, L. J., & Youngquist, H. W. (1976). Management of impacted canines. American Journal of Orthodontics, 69(4), 371–387.

Bourzgui, F., Aghoutan, H., & Diouny, S. (2013). Craniomandibular disorders and mandibular reference position in orthodontic treatment. International Journal of Dentistry, 2013.

Brusveen, E.M.G., Brudvik, P., Bøe, O.E., & Mavragani, M. (2012). Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: A radiographic study. American Journal of Orthodontics and Dentofacial Orthopedics, 141(4), 427–435.

Cacciatore, G., Poletti, L., & Sforza, C. (2018). Early diagnosed impacted maxillary canines and the morphology of the maxilla: a three-dimensional study. Progress in Orthodontics, 19(1), 20–20.

Chauhan, D., Datana, S., Agarwal, S. S., Vishvaroop, & Varun, G. (2022). Development of difficulty index for management of impacted maxillary canine: A CBCT-based study. Medical Journal Armed Forces India, 78(1), 61–67.

Clemente-Napimoga, J.T., Silva, M.A.S.M., Peres, S.N.C., Lopes, A.H.P., Lossio, C.F., Oliveira, M.V., Osterne, V.J.S., Nascimento, K.S., Abdalla, H.B., Teixeira, J.M., Cavada, B.S., & Napimoga, M.H. (2019). Dioclea violacea lectin ameliorates inflammation in the temporomandibular joint of rats by suppressing intercellular adhesion molecule-1 expression. Biochimie, 158, 34–42.

Cruz, R.M. (2019). Orthodontic traction of impacted canines: Concepts and clinical application. Dental Press Journal of Orthodontics, 24(1), 74–87.

Da Silva, A.C., Capistrano, A., De Almeida-Pedrin, R.R., Cardoso, M.D.A., Conti, A.C.D. C.F., & Capelozza Filho, L. (2017). Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation. Journal of Applied Oral Science, 25(1), 75–81.

Dachi, S.F., & Howell, F.V. (1961a). A survey of 3,874 routine full-mouth radiographs. II. A study of impacted teeth. Oral Surgery, Oral Medicine, Oral Pathology, 14(10), 1165–1169.

Dachi, S.F., & Howell, F.V. (1961b). A survey of 3,874 routine full-mouth radiographs. II. A study of impacted teeth. Oral Surgery, Oral Medicine, Oral Pathology, 14(10), 1165–1169.

de Araujo, C. M., Trannin, P. D., Schroder, A. G. D., Stechman-Neto, J., Cavalcante-Leão, B. L., Mattos, N. H. R., Zeigelboim, B. S., Santos, R. S., & Guariza-Filho, O. (2020). Surgical-Periodontal aspects in orthodontic traction of palatally displaced canines: a meta-analysis. Japanese Dental Science Review, 56(1), 164–176.

Greco, M., & Machoy, M. (2022). Impacted Canine Management Using Aligners Supported by Orthodontic Temporary Anchorage Devices. International Journal of Environmental Research and Public Health 2023, 20(1), 131.

Grenga, C., Guarnieri, R., Grenga, V., Bovi, M., Bertoldo, S., Galluccio, G., Di Giorgio, R., & Barbato, E. (2021). Periodontal evaluation of palatally impacted maxillary canines treated by closed approach with ultrasonic surgery and orthodontic treatment: a retrospective pilot study. Scientific Reports, 11(1), 1–9.

Jacobs, S.G. (1999). Localization of the unerupted maxillary canine: How to and when to. American Journal of Orthodontics and Dentofacial Orthopedics, 115(3), 314–322.

Jacoby, H. (1983). The etiology of maxillary canine impactions. American Journal of Orthodontics, 84(2), 125–132.

Jena, A.K., Duggal, R., & Parkash, H. (2010). The distribution of individual tooth impaction in general dental patients of northern india. Community Dental Health, 27(3), 184–186.

Koutzoglou, S.I., & Kostaki, A. (2013). Effect of surgical exposure technique, age, and grade of impaction on ankylosis of an impacted canine, and the effect of rapid palatal expansion on eruption: A prospective clinical study. American Journal of Orthodontics and Dentofacial Orthopedics, 143(3), 342–352.

Kramer, R.M., & Williams, A.C. (1970). The incidence of impacted teeth. A survey at Harlem Hospital. Oral Surgery, Oral Medicine, Oral Pathology, 29(2), 237–241.

Levander, E., & Malmgren, O. (1988). Evaluation of the risk of root resorption during orthodontic treatment: A study of upper incisors. European Journal of Orthodontics, 10(1), 30–38.

Lewis, P.D. (1971). Preorthodontic surgery in the treatment of impacted canines. American Journal of Orthodontics, 60(4), 382–397.

Li, L., Stoop, R., Clijsen, R., Hohenauer, E., Fernández-De-Las-Peñas, C., Huang, Q., & Barbero, M. (2020). Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. Clinical Journal of Pain, 36(12), 955–967.

Maltha, J.C., van Leeuwen, E.J., Dijkman, G.E.H.M., & Kuijpers-Jagtman, A.M. (2004). Incidence and severity of root resorption in orthodontically moved premolars in dogs. Orthodontics & Craniofacial Research, 7(2), 115–121.

Martín Berrocal, A., Pedro Pascual, A., Martín Baranera, M., Tinoco González, J., & Mateo Lozano, S. (2018). Relación entre síndrome de disfunción temporomandibular y síndrome de latigazo cervical tras un accidente de tráfico. Estudio de cohortes. Fisioterapia, 40(5), 232–240.

McBride, L.J. (1979). Traction—a surgical/orthodontic procedure. American Journal of Orthodontics, 76(3), 287–299.

Modi, P., Aggarwal, S., Bhatia, P., & Modi, P. (2016). Smart sliding hook as a ready to use auxillary in orthodontist׳s inventory. Singapore Dental Journal, 37, 27–32.

Montes Díaz, M.E. (2022). Características morfológicas esqueléticas y dentoalveolares del maxilar superior, en pacientes con caninos incluidos por palatino utilizando tomografía computerizada de haz cónico: un estudio retrospectivo [Tesis CEINDO, Univesidad San Pablo CEO].

Montiel Ramos, R. R., Cabrera, G. C., Urgiles, C. U., & Centeno, F. J. (2018). Aspectos metodológicos de la investigación Methodological aspects of the investigation Revista Científica de Investigación actualización del mundo de las Ciencias. Revista Científica de Investigación Actualización Del Mundo de Las Ciencias, 2(3), 194–211.

Oliver, R.G., Mannion, J.E., & Robinson, J.M. (1989). Morphology of the Maxillary Lateral Incisor in Cases of Unilateral Impaction of the Maxillary Canine. Journal of Orthodontics, 16(1).

Parkin, N.A., Milner, R.S., Deery, C., Tinsley, D., Smith, A.M., Germain, P., Freeman, J.V., Bell, S.J., & Benson, P.E. (2013). Periodontal health of palatally displaced canines treated with open or closed surgical technique: A multicenter, randomized controlled trial. American Journal of Orthodontics and Dentofacial Orthopedics, 144(2), 176–184.

Peck, S. (1995). The palatally displaced canine as a dental anomaly of genetic origin. Angle Orthod, 65, 95–102.

Pignoly, M., Monnet-Corti, V., & Le Gall, M. (2016). Reason for failure in the treatment of impacted and retained teeth. L’Orthodontie Française, 87(1), 23–38.

Poluha, R.L., De La Torre Canales, G., Costa, Y.M., Grossmann, E., Bonjardim, L.R., & Conti, P.C.R. (2019). Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation. Journal of Applied Oral Science, 27, e20180433.

Priyank, H., Shankar Prasad, R., Shivakumar, S., Sayed Abdul, N., Pathak, A., Cervino, G., Cicciù, M., & Minervini, G. (2023). Management protocols of chronic Orofacial Pain: A Systematic Review. The Saudi Dental Journal, 35(5), 395–402.

Ramírez-Caro, S.N., Espinosa De Santillana, I.A., & Muñoz-Quintana, G. (2015). Prevalence of temporomandibular disorders in Mexican children with mixed dentition. Rev. Salud Pública, 17(2), 289–299.

Ravi, I., Srinivasan, B., & Kailasam, V. (2021). Radiographic predictors of maxillary canine impaction in mixed and early permanent dentition – A systematic review and meta-analysis. International Orthodontics, 19(4), 548–565.

Schubert, M., Proff, P., & Kirschneck, C. (2018). Improved eruption path quantification and treatment time prognosis in alignment of impacted maxillary canines using CBCT imaging. European Journal of Orthodontics, 40(6), 597–607.

Servais, J.A., Gaalaas, L., Lunos, S., Beiraghi, S., Larson, B.E., & Leon-Salazar, V. (2018). Alternative cone-beam computed tomography method for the analysis of bone density around impacted maxillary canines. American Journal of Orthodontics and Dentofacial Orthopedics, 154(3), 442–449.

Sharma, M., Sharma, V., & Khanna, B. (2012). Mini-screw Implant or Transpalatal Arch-Mediated Anchorage Reinforcement during Canine Retraction: A Randomized Clinical Trial, Journal of Orthodontics, 39(2), 102–110.

Smailiene, D., Kavaliauskiene, A., & Pacauskiene, I. (2013). Posttreatment Status of Palatally Impacted Maxillary Canines Treated Applying 2 Different Surgical-Orthodontic Methods. Medicina, 49(8), 55.

Smailiene, D., Kavaliauskiene, A., Pacauskiene, I., Zasciurinskiene, E., & Bjerklin, K. (2013). Palatally impacted maxillary canines: choice of surgical-orthodontic treatment method does not influence post-treatment periodontal status. A controlled prospective study. European Journal of Orthodontics, 35(6), 803–810.

Sosars, P., Jakobsone, G., Neimane, L., & Mukans, M. (2020). Comparative analysis of panoramic radiography and cone-beam computed tomography in treatment planning of palatally displaced canines. American Journal of Orthodontics and Dentofacial Orthopedics, 157(5), 719–727.

Tahmasebi, E., Mohammadi, M., Alam, M., Abbasi, K., Gharibian Bajestani, S., Khanmohammad, R., Haseli, M., Yazdanian, M., Esmaeili Fard Barzegar, P., & Tebyaniyan, H. (2023). The current regenerative medicine approaches of craniofacial diseases: A narrative review. Frontiers in Cell and Developmental Biology, 11, 1112378.

Ullaguari-Landeta, M., & Gallegos, A. C. (2021). Tracción quirúrgica de canino retenido maxilar asociado a la presencia de un odontoma, diagnóstico radiográfico. Reporte de un caso. Revista KIRU, 18(1).

van Selms, M.K.A., Ahlberg, J., Lobbezoo, F., & Visscher, C.M. (2017). Evidence-based review on temporomandibular disorders among musicians. Occupational Medicine, 67(5), 336–343.

Vitale, M.C., Nardi, M.G., Pellegrini, M., Spadari, F., Pulicari, F., Alcozer, R., Minardi, M., Sfondrini, M.F., Bertino, K., & Scribante, A. (2022). Impacted Palatal Canines and Diode Laser Surgery: A Case Report. Case Reports in Dentistry, 2022.

Wetselaar, P., Manfredini, D., Ahlberg, J., Johansson, A., Aarab, G., Papagianni, C. E., Reyes Sevilla, M., Koutris, M., & Lobbezoo, F. (2019). Associations between tooth wear and dental sleep disorders: A narrative overview. Journal of Oral Rehabilitation, 46(8), 765–775.

Wieckiewicz, M., Boening, K., Wiland, P., Shiau, Y.Y., & Paradowska-Stolarz, A. (2015). Reported concepts for the treatment modalities and pain management of temporomandibular disorders. Journal of Headache and Pain, 16(1), 1–12.

Woloshyn, H., Artun, J., Kennedy, D.B., & Joondeph, D.R. (1994). Pulpal and periodontal reactions to orthodontic alignment of palatally impacted canines. The Angle Orthodontist, 64(4), 257–264.

Yan, B., Sun, Z., Fields, H., & Wang, L. (2015). Maxillary canine impaction increases root resorption risk of adjacent teeth: A problem of physical proximity. L’Orthodontie Française, 86(2), 169–179.

Yang, S., Yang, X., Jin, A., Ha, N., Dai, Q., Zhou, S., Yang, Y., Gong, X., Hong, Y., Ding, Q., & Jiang, L. (2019). Sequential traction of a labio-palatal horizontally impacted maxillary canine with a custom three-directional force device in the space of a missing ipsilateral first premolar. The Korean Journal of Orthodontics, 49(2), 124–136.

Zeno, K.G., El-Mohtar, S.J., Mustapha, S., & Ghafari, J.G. (2019). Finite element analysis of stresses on adjacent teeth during the traction of palatally impacted canines. The Angle Orthodontist, 89(3), 418–425.

Zhang, J., Wang, X. xia, Ma, S. liang, Ru, J., & Ren, X. sheng. (2008). 3-dimensional finite element analysis of periodontal stress distribution when impacted teeth are tracted. Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi Kouqiang Yixue Zazhi = West China Journal of Stomatology, 26(1), 19–22.

How to Cite
Cruz Gallegos, V. A., & Puebla Ramos, L. (2023). Impacted canines. A review of modern literature. Religación, 8(38), e2301112.
Health Sciences