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Project

What’s in a canine; development of clinical guidance notes for autogenous transplantation of maxillary canines.

Impacted maxillary canines can present themselves in a variety of ways. In the vast majority of cases, the routine treatment approach is sufficient and the clinician will achieve a successful end result. However, there is a subset of critical impactions where this standardized approach may fall short and the choice is ultimately made to remove the canine. The overall aim of this thesis was to compose recommendations that will help to identify critically impacted maxillary canines and at the same time support the decision-making process for further treatment options.

Chapters 1 and 2 introduce reliable and objective indices for the evaluation of the aesthetic and radiographic outcomes of impacted maxillary canines after treatment. In Chapter 3, the existing literature was reviewed for cases of critical maxillary canine impactions and treatment options. A definition for critical maxillary canine impaction is suggested.

In Chapter 4, a retrospective investigation of our own patient population, using 3D imaging, was performed to assess the different locations and associated pathology of impacted maxillary canines.
In Chapter 5, we reviewed the literature for a possible relationship between the initial position of the maxillary canine and the treatment outcome.

In Chapter 6, a retrospective study on the outcome of maxillary canines after surgical exposure and orthodontic traction was performed, in order to investigate possible predictors of treatment success.
In Chapter 7, the literature was systematically reviewed for autotransplantation of impacted maxillary canines. With this study, we aimed to give updated methodological information on the diagnostic and therapeutic pathways for trans-alveolar transplantation of maxillary canines and the long-term outcomes.

Using the indices from the first two chapters, a retrospective study (Chapter 8) was designed to study the long-term outcome following autotransplantation of maxillary canines. Using the same indices, a prospective study (Chapter 9) investigated the short-term outcome, while using standardized intake, surgery and follow-up procedures.

The findings of this doctoral thesis show that there is a subgroup of critically impacted maxillary canines with increased failure rates after standardized treatment. Autotransplantation of these canines has proven to have acceptable short- and long- term outcomes. However, other treatment alternatives should further be investigated.

To summarize, this thesis focuses on autotransplantation as a treatment option for critically impacted maxillary canines. Understanding and defining critical canine impaction will help in clinical practice. The goal was to identify critically impacted maxillary canines and at the same time support the decision-making process for further treatment options.

Date:1 Apr 2018 →  7 Jun 2021
Keywords:Dento alveolar surgery, Canine impaction
Disciplines:Laboratory medicine, Palliative care and end-of-life care, Regenerative medicine, Other basic sciences, Other health sciences, Nursing, Other paramedical sciences, Other translational sciences, Other medical and health sciences
Project type:PhD project