Clinical Outcome of an Impacted Maxillary Canine: From Exposition to Occlusion

Abstract

Aim: The aim is to report a case of impacted maxillary right canine successfully positioned into the occlusion line. Background: Although the treatment of choice for an impacted canine is a combined surgical-orthodontic approach, there are differences in technique. The preorthodontic uncovering and autonomous eruption technique is a safe and predictable option for the treatment of palatally impacted maxillary canines in adolescents and adults as is the orthodontic creation of a space before minimal surgical exposure, the bonding of a small attachment (an eyelet), full-flap closure, and immediate traction. Although the mechanical management of impacted teeth is a routine task for most orthodontists, certain types of impaction can be frustrating. Case description: An 18-year-old adult patient presented for clinical examination with a mobile maxillary right deciduous canine, the absence of a maxillary right permanent canine, Angle Class I malocclusion, an overjet of 2.0 mm, an overbite of 3.0 mm, and rotated canine and left maxillary central and lateral incisors. Cephalometric measurements revealed a skeletal Class I relationship as well as upright maxillary incisors (1. NA = 18º) and mandibular incisors (1. NB = 16º, IMPA = 80º). The facial profile was concave. Clinically, a constricted maxillary arch was observed, and the patient had a nail-biting habit. Conclusion: The canine was aligned, leveled and positioned in the occlusion line. The aesthetic, functional and periodontal results remained stable in the retention phase. Clinical significance: Various treatment strategies are available to treat impacted maxillary canines. The surgical, periodontal, and orthodontic considerations in the management of impacted canines must be clearly explained to the patient.