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The premature loss of the mandibular primary canine is relatively frequent and a sign of the upcoming space problems in the transitional period. This situation is caused by the permanent lateral incisor resorbing the root of the primary canine during its eruption. Bilateral loss of primary canines in a crowded arch leads to the lingual tipping of the permanent incisors, with the consequent reduction in the arch perimeter and increase in overbite. When the loss of a primary canine is unilateral, tipping of the adjacent incisors occurs toward the space, resulting in midline deviation. In these situations, treatment possibilities, such as extraction of the antimeric tooth or placement of a passive lingual arch, can be applied; although there are some controversies concerning this. Most space problems with less than 4 mm can be resolved through preservation of the leeway space using sequential disking of the primary teeth and a passive lingual arch, regaining space or limited arch expansion in the late mixed dentition. In cases with 4~6 mm of space problems, arch expansion (A-P or transverse) can be applied. Space problems with more than 6 mm should be treated through diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth including serial extraction (guidance of eruption).

Clinical Implications of the Premature Loss of the Mandibular Primary Canine