75 - Diagnostic algorithm for localization and complexity assessment of impacted maxillary canines

Abstract

Accurate diagnosis and evaluation of treatment complexity in maxillary canine impaction are essential for effective orthodontic planning. This study aimed to determine the prevalence and causes of canine impaction and to develop a diagnostic scoring system to assess treatment difficulty based on clinical and radiological criteria. A retrospective analysis of 11,704 patient records from the “Ortho-1” clinic over 35 years identified 255 cases of impaction of tooth 13 (2.17%) and 290 cases of tooth 23 (2.47%). Bilateral impaction was found in 94 cases (0.8%). Statistical analysis was performed in 44 patients who completed orthodontic treatment for bilateral impaction. A diagnostic index was developed based on: 1.⁠ ⁠Angulation to the midline (1–3 points), 2.⁠ ⁠Vertical depth relative to three occlusal reference lines (1–3 points), 3.⁠ ⁠Mesiodistal displacement (0–2 points), 4.⁠ ⁠Presence of complicating factors such as supernumerary teeth, odontomas, cysts, or rotations (0–1 point). The total score defines treatment difficulty: • 2–3 points: mild, • 4–5: moderate, • 6–9: severe. A statistically significant correlation was found between the total score and treatment duration. Higher scores were associated with increased treatment time and risk of complications. The proposed algorithm allows for more precise localization of impacted canines, individualized prognosis, and optimized treatment planning.