The Effects of 3-D Skeletal Patterns on Maxillary Canine Impaction: A Single-Center Retrospective Study

Aim Maxillary canine impaction is a multifactorial condition influenced by local, systemic, and genetic factors, and may adversely affect esthetics, function, and occlusal stability. Although several etiologic factors have been suggested, the influence of skeletal patterns on impaction remains unclear. This study aimed to investigate the association between sagittal, vertical, and transverse skeletal patterns and maxillary canine impaction using lateral and posteroanterior cephalometric radiographs. Materials and Methods This retrospective study included lateral and posteroanterior cephalometric radiographs of 100 individuals (mean age 15.85 ± 1.69) with at least one maxillary impacted canine from the archives of Ankara University. Impaction was diagnosed based on chronological eruption age, intraoral photographs, and panoramic radiographs. Sagittal skeletal relationships were assessed using SNA, ANB, and Witts measurements; vertical relationships were evaluated with GoGn/SN and FH/MP angles. Transverse skeletal dimensions (JR–JL, JR–ZAg, JL–ZAg, Ag–Ag) were analyzed according to Ricketts’ analysis and compared with a control group without impacted canines. Measurements were performed by a single examiner using Dolphin and AutoCAD. Statistical analyses were conducted with SPSS 26, and transverse comparisons were evaluated with independent samples t-tests (p < 0.05). Results Sagittal evaluation showed the highest impaction frequency in individuals with normal maxillary position and skeletal Class I patterns. Witts analysis supported these findings for both sexes. Vertically, hyperdivergent individuals demonstrated the highest prevalence of impaction. Transverse evaluation revealed significantly reduced maxillary transverse dimensions in the impaction group, with higher JR–JL and lower JR–ZAg and JL–ZAg values (p < 0.05). Conclusion Skeletal patterns may influence maxillary canine impaction, with transverse deficiency showing the strongest association. Comprehensive evaluation of all three planes is essential for accurate risk assessment. Further multicenter studies with larger samples are recommended.