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 Table of Contents  
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 93-95

Canine impaction among riyadh population: A single center experience

1 General Dentist, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
2 Consultant Orthodontics, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia

Date of Web Publication8-Jan-2018

Correspondence Address:
Dr. Shaima Bin Melha
Riyadh Colleges of Dentistry & Pharmacy, POBOX 84891, Riyadh 11681
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijohs.ijohs_52_17

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Aim: The aim of this study is to assess canine tooth impaction (TI) among population of Riyadh, Saudi Arabia.
Subjects and Methods: We performed a retrospective analysis of 2157 patients' panoramic radiographs who visited any of the three campuses of Riyadh Colleges of Dentistry and Pharmacy clinics between August 2014 and May 2015. Analysis was performed specifically for the purpose of this study.
Results: Among the 2157 panoramic radiographs analyzed, we found canine impaction in 79 patients (3.65% of the total sample size). Seventy-three cases had maxillary canine impaction (3.37% of the total population) and eight patients with mandibular canine impaction.
Conclusions: Higher than the reported figures, in this large cohort of Riyadh population reviewed, canine TI is 3.6%.

Keywords: Canine, impaction, mandibular canine, maxillary canine, panoramic radiographs

How to cite this article:
Melha SB, Alturki S, Aldawasri G, Almeshari N, Almeshari S, Albadr K. Canine impaction among riyadh population: A single center experience. Int J Oral Health Sci 2017;7:93-5

How to cite this URL:
Melha SB, Alturki S, Aldawasri G, Almeshari N, Almeshari S, Albadr K. Canine impaction among riyadh population: A single center experience. Int J Oral Health Sci [serial online] 2017 [cited 2020 Jun 5];7:93-5. Available from: http://www.ijohsjournal.org/text.asp?2017/7/2/93/222407

  Introduction Top

Tooth impaction (TI) is a condition in which a tooth is embedded in the alveolus and is locked-in due to malposition or obstruction in the eruption path into oral cavity.[1] Tooth is considered impacted when its eruption is delayed for a minimum of 2 years after the corresponding mean age of eruption.[2] Causes of TI includes several systemic and local factors; however, the exact mechanism is not well-known.[3] TI is common in dental practice between teenagers and adults, with the third molar TI being the most common.[4],[5] Canine impaction is a well-documented phenomenon in literature and is considered as challenge to the dentist.[6] It is more predominant in females than males and more facially located than palatally.[7],[8] In this study, we tried to determine the percentage of canine impaction among Riyadh population, the capital of Saudi Arabia who visited our dental clinics in 2014 and 2015.

  Subjects and Methods Top

In this study, we performed a retrospective analysis of 2157 patients (1067 males and 1090 females) who presented to Riyadh Colleges of Dentistry and Pharmacy in our three campuses, Riyadh, Saudi Arabia, between the year of 2014 and 2015. All panoramic radiographs obtained for them were taken with standardized equipment and specification (ORTHOPHOS XG 5, Sirona Dental Company). For all the reviewed radiographs, canine TI was considered if: (1) the tooth was not exposed to the oral cavity and (2) the age of the patient was between 15 and 40 years of age. Patients who had a history of previous orthodontic treatment, patients with a history of environmental conditions (i.e., trauma) and those with hereditary problems (i.e., cleft palate) were excluded from the study. We extracted the data manually from medical records to a Microsoft Excel program sheet. Then, we evaluated the calculated percentages of canine impaction in both the panoramic radiographs and dental records.

Statistical analysis

All statistical analyses were performed using Stata version 12 (StataCorp., 2012. Stata Statistical Software: Release 12., StataCorpLP, College Station, TX, USA). Baseline demographic and clinical were summarized in the form of means ± standard deviation for continuous variables, and counts and percentage for categorical variables. This summery was presented for the total study population, then by gender. Comparison between males and females were done using the student's t test for the normally distributed continuous variables, and Chi-square test for categorical variables. If there was cell in any contingency table from the cross tabulating the categorical variables with expected frequency <5, we calculated the Fisher's exact test's P value. For all statistical tests, a P < 0.05 was considered as statistically significant. We only analyzed these radiography for the purpose of this study specifically. We also the reported some problems in relation to canine impaction for future studies space condition such as available spaces for those un-erupted impacted teeth, teeth eruption problems, dental transmigration, and retained primary teeth.

  Results Top

We analyzed 2157 panoramic radiographs, 1067 for males (49.68%) and 1090 females (50.32%). The mean age of the total study population is 27.2 years, (males 27.6 and females 26.8 years). In the present study, we found canine impaction in 79 patients (3.65% of the total sample size), 35 male patients (3.25%) and 44 female patients (4.04%). We found maxillary canine impaction with 73 cases representing 3.37% of the total population (31 males and 42 cases females). Moreover, mandibular canine impaction was found in 8 patients, 5 in males and 3 in females [Table 1].
Table 1: Population mean age, percentages of tooth impaction

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In our analysis, we found impaction can be single, or bilateral for both maxillary and mandibular impactions. No statistically significant differences found in the results, except for the left maxillary canine impaction with P = 0.004 as shown in [Figure 1].
Figure 1: Total canine impaction in population

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  Discussion Top

To the best of our knowledge, there is the first study in the Saudi dental literature, which discusses canine impaction among Riyadh residents. This study sample size is similar to many international studies.[2],[6],[7],[8] We included all patients between 15 and 40 years of age presented to Riyadh Colleges of Dentistry and Pharmacy three different campuses located at different areas in Riyadh, capital of Saudi Arabia were included in the study. Since it might affect impaction, we eliminated all patients who had a history of previous orthodontic treatment, patients with a history of environmental conditions, and hereditary problems (such as Cleft palate). In our study, we found canine impaction is 3.65% of the total population (79 patients) with a higher rate among females (4.04%) vs. (3.25%) in males. Regarding our methodology, we believe, radiographic examination from specific populations seems to be the most common practical approach, however, since it is considered a retrospective analysis, carries a risk of bias. We believe to truly determine the actual prevalence of any TI, a representative and randomized sample of the general population is required.

Looking into similar studies from Saudi Arabia (but different regions), we found small differences in the published figures. In a random sample to study the different reasons of dental anomalies from the Western part of Saudi Arabia, the prevalence of upper canine impaction in a cohort of 878 cases included is 3.3%.[9] In the Southern region of the country, Mustafa found the impacted canine prevalence is to be around 1.44%.[10] Worldwide, numerous studies have been proposed to investigate the incidence and the prevalence of canine impaction in different populations with variable results. High prevalence is found in western societies (9.9% in Australia, 8.8% in Greece) while the lowest reported prevalence in Japan (0.27%).[7],[11] In Turkey, the incidence of maxillary canine impaction was 3.29% while the incidence of mandibular canine's impaction was found to be only 0.44%.[12] In India, the reported figures in a large series of full mouth dental radiographs, maxillary canine impaction is approximately 3%.[2] Consistent with the literature,[13],[14] in our cohort, maxillary canine impaction occurs more frequently than mandibular canines (3.37% and 0.37%), respectively, with higher percentage in females (3.85%) than to males (2.88%). We also showed that canine impaction could sometimes arise bilaterally. In this cohort, we found bilateral impaction in 27.4% of patients, versus 72.6% with unilateral impaction. Essentially, it is not unusual for maxillary canine impaction to occur bilaterally, although unilateral ectopic eruptions are more frequent. In some studies, bilateral impaction can be as high as 8%–10% of impactions.[11] However, on the contrary, some studies have demonstrated a higher prevalence of unilateral canine impaction.[11] In regard to the difference of TI impaction between males and females, this can be explained by the differences in growth pattern between the two. In addition, canine tooth has a complicated eruption pattern and is one of the last teeth to erupt in dental arch.[14] Therefore, this tooth may not have an eruption process in a natural way.[15] Finally, we believe, early detection of impacted canines is very important matter from a therapeutic point of view to reduces treatment time, complexity of treatment and the subsequent complications. Ideally, patients should be examined by the age of 8 or 9 years to determine whether the canine is displaced from the normal position in the alveolus and assess the further potential for its impaction, As well, the clinician can investigate the presence a position of the canine.

  Conclusions Top

Higher the previously reported incidence, in this study we found that canine impaction is about 3.65% among this cohort of individuals visiting our clinics in Riyadh, Saudi Arabia. We found maxillary canine impaction in 73 cases (3.37% of the total population) and mandibular canine impaction in eight patients. These findings can be added to other studies performed in other provinces of Saudi Arabia. Therefore, a useful clinical database of the Saudi population can be created.


We would like to thank Riyadh Colleges of Dentistry and Pharmacy research department for the support and for providing us the access to data.

Financial support and sponsorship


Conflicts of interest

There are no conflflicts of interest.

  References Top

American association of oral and maxillofacial surgeons. Impacted teeth. Oral Health 1998;88:31-2.  Back to cited text no. 1
Patil S, Maheshwari S. Prevalence of impacted and supernumerary teeth in the North Indian population. J Clin Exp Dent 2014;6:e116-20.  Back to cited text no. 2
Grover PS, Lorton L. The incidence of unerupted permanent teeth and related clinical cases. Oral Surg Oral Med Oral Pathol 1985;59:420-5.  Back to cited text no. 3
Dachi SF, Howell FV. A survey of 3, 874 routine full-month radiographs. II. A study of impacted teeth. Oral Surg Oral Med Oral Pathol 1961;14:1165-9.  Back to cited text no. 4
Roberts-Harry D, Sandy J. Orthodontics. Part 10: Impacted teeth. Br Dent J 2004;196:319-27.  Back to cited text no. 5
Gashi A, Kamberi B, Ademi-Abdyli R, Perjuci F, Sahatçiu-Gashi A. The incidence of impacted maxillary canines in a kosovar population. Int Sch Res Notices 2014;2014:370531.  Back to cited text no. 6
Tassara G, Lopez L, Hanke R, Tumanyan S, Picon F. Prevalence of impacted maxillary canines in Puerto Rican adolescents. Int J Health Sci 2015;3:135-8.  Back to cited text no. 7
Kramer RM, Williams AC. The incidence of impacted teeth. A survey at Harlem hospital. Oral Surg Oral Med Oral Pathol 1970;29:237-41.  Back to cited text no. 8
Afify AR, Zawawi KH. The prevalence of dental anomalies in the Western region of Saudi Arabia. ISRN Dent 2012;2012:837270.  Back to cited text no. 9
Mustafa A. Prevalence of impacted canine teeth in college of dentistry, King Khalid University – A retrospective study. Int J Health Sci Res 2014;4:211-4.  Back to cited text no. 10
Fardi A, Kondylidou-Sidira A, Bachour Z, Parisis N, Tsirlis A. Incidence of impacted and supernumerary teeth – A radiographic study in a North Greek population. Med Oral Patol Oral Cir Bucal 2011;16:e56-61.  Back to cited text no. 11
Aktan AM, Kara S, Akgünlü F, Malkoç S. The incidence of canine transmigration and tooth impaction in a Turkish subpopulation. Eur J Orthod 2010;32:575-81.  Back to cited text no. 12
Bishara SE. Impacted maxillary canines: A review. Am J Orthod Dentofacial Orthop 1992;101:159-71.  Back to cited text no. 13
Cooke J, Wang HL. Canine impactions: Incidence and management. Int J Periodontics Restorative Dent 2006;26:483-91.  Back to cited text no. 14
Richardson G, Russell KA. A review of impacted permanent maxillary cuspids – Diagnosis and prevention. J Can Dent Assoc 2000;66:497-501.  Back to cited text no. 15


  [Figure 1]

  [Table 1]

This article has been cited by
1 Prevalence and pattern of impacted canines in Najran, South Western Saudi Arabian population
Bandar Alyami,Ramat Braimah,Saeed Alharieth
The Saudi Dental Journal. 2019;
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