At the 10-year recall, if a buccal canine bulge isn’t palpable by 11 or there’s asymmetry, a pano — and small-FOV CBCT when the pano is inconclusive — helps us formulate a patient-specific interceptive plan, commonly extraction of Cs and, where indicated, light expansion. I keep a brief referral template that flags space analysis and skeletal pattern; happy to share, and I’m interested in your imaging thresholds and timing triggers.
Same here — if “no buccal bulge by 11” and the pano shows a mesially tipped lateral root, I’ll extract the C that day and book a 6–9 month review; CBCT only if no shift by then. Quick tip: record canine palpation and midline at the 10-year recall so assistants auto-flag asymmetry; keeps scans and referrals focused. @OP would love your template; Ericson & Kurol on timing still holds up: No cytogenetic effects of quinolone treatment in humans - PubMed.
@OP I use >25° to midline on pano to extract C; small-FOV CBCT only if asymmetry persists.
Quick example: at 10y10m with no buccal bulge, I draw a line through the lateral’s root on the pano and if the canine cusp tip crosses that midline, I flag it on the referral for space/skeletal pattern and book a 4‑month re‑palpation rather than wait a year. For localization I still do two periapicals with about 20° parallax before ‘small-FOV CBCT’ to keep dose down, @OP.