## 4 Discussion  
The results of the case-controlled study show that patients with impacted canines are more likely to have smaller maxillary dimensions, a deep bite, hypoplastic lateral incisors, or rotated teeth adjacent to the canines. The presence of a persistent deciduous canine and a larger canine axis angle are local risk factors that increase the likelihood of canine impaction. In patients with impacted canines, there is a greater need for surgical exposure if persistent deciduous teeth are present, if the impacted canine is palatal, or if its axial angle is greater. The majority of impacted canines (59%) belonged to female participants, suggesting that maxillary canines are more common in girls, which has been previously reported in several reports [3,14]. However, since the design of our study is the case control, we cannot fully confirm this. The control group matched the experimental group in terms of gender, age, and skeletal maturity and might, therefore, not be representative of the general population in this respect. The palatal location of impacted maxillary canines was present in 83.8% of canines, while six impacted canines were located buccally, which is comparable to the results of other studies [3,14,32]. Problems with the eruption of maxillary maxillary canines are relatively common; they may be influenced by either intraoral conditions or local risk factors [33]. The impaction of maxillary canines is often associated with various intraoral conditions, such as a deep bite, a hypoplastic later incisor, rotation of neighbouring teeth, or ankylosis of deciduous teeth [8,33]. The results of our study show that patients with impacted canines have a deep bite significantly more often. A deep bite was present in 54.8% of the participants in the experimental group. A similar association was also found in previous studies: [PERSON] reported that 44% of patients with impacted canines also had a deep bite, while [PERSON] reported 33.5% [34,35]. This association is explained by the guidance theory: the roots of \begin{table}
\begin{tabular}{c c c c c} \hline  & & \
\begin{tabular}{c} **Need for Surgical** \\ **Exposure** \\ \end{tabular} &
\begin{tabular}{c} **No Need for Surgical** \\ **Exposure** \\ \end{tabular} & \\ \hline \multirow{4}{*}{**Deciduous canine**} & **Present (N)** & **24** & **14** & *** \(p<0.001\)** \\  & \(expected\) (\(N\)) & \(16.44\) & 20.55 & (chi-square test) \\  & **Not present (N)** & **4** & **22** & OR: 10.15 \\  & \(expected\) (\(N\)) & \(11.55\) & \(14.44\) & 95\% CI: 2.988–35.84 \\ \hline \multirow{4}{*}{**Location of impacted**} & **Palatal (N)** & **21** & **10** & *** \(p<0.001\)** \\  & \(expected\) (\(N\)) & \(13.78\) & \(17.22\) & (chi-square test) \\ \cline{1-1}  & **Buccal (N)** & **7** & **25** & OR: 7.5 \\ \cline{1-1}  & \(expected\) (\(N\)) & \(14.22\) & \(17.78\) & 95\% 2.43–23.14 \\ \hline \multirow{4}{*}{**Canine axis angle**} & **Median** & **39\({}^{\circ}\)** & **5\({}^{\circ}\)** & *** \(p<0.001\)** \\  & **Interquartile range** & **30.5–49\({}^{\circ}\)** & **0–31\({}^{\circ}\)** & **(Mann-Whitney test)** \\ \hline \end{tabular} \({}^{*}\)Statistically significant, \(p<0.05\).  
\end{table} 
Table 4: Comparison of the presence of local risk factors for impaction and need for surgical exposure of impacted canines. the retroinclined maxillary incisors are more buccal, and the root tips of the lateral incisors are often more mesial so that these roots cannot guide the eruption of the canine, which can get displaced palatally and possibly impacted. In addition, there may be a common genetic factor that causes a deep bite with retro-inclination of the incisors and impaction of the canines [36]. The prevalence of hypoplastic lateral incisors in the general population is approximately 1.8% and varies by race, ethnicity, and gender [37].