Multidisciplinary treatment of an impacted maxillary canine with immediate implant installation

Abstract

Maxillary permanent canines are the second most frequent cases of impacted teeth; their resolution demands a multidisciplinary evaluation to delineate a viable treatment plan based on the individual esthetic and functional outcomes required. An impacted maxillary permanent canine which was ankylosed in a horizontal position was extracted followed by a regeneration technique, filling the bone defect with biomaterial. An implant was immediately installed in the alveolus of the extracted deciduous canine, and a connective tissue graft was buccally positioned. After the osseointegration period, a modified Palacci and Nowzari surgical technique was performed to gain papilla, and the implant was loaded with an interim restoration with a proper profile to manipulate the soft-tissue contour. Finally, the definitive restauration was cemented achieving the desired outcomes. The achieved clinical outcomes remain stable during a 2-year follow-up. A successful management of this challenge esthetic case lies in the details at surgical and prosthetic phases based in biological response of the peri-implant tissues.

A Rare Case of All 4 Permanent Canines Impacted-Radiographic Finding: Case Report

“…The canines play an important role in facial appearance, dental esthetics, arch development, and occlusion and its impaction of the maxillary canines is twice common as the mandible [1]. The maxillary canine is second only to the mandibular third molar in its frequency of impaction, with a rate that varies from 0.2 to 3.0% [2][3][4][5]. The impaction of the mandible canine is much lower than the maxillary [2].…”

“…2D X-ray examination, such as Panoramic has been used to locate impacted tooth, but with the appearance of the CBCT-Cone Beam Computed Tomography, this 3D examination has become the golden standard for the location and spatial position of the impacted tooth [3,4,7,8]. The treatment of the impacted canines varies from orthodontic extrusion, aligners, fixed appliance, surgical removal [2,5,9,10]. Regarding the impaction of the maxillary canines, the morphology and skeletal characteristics of the maxilla play an important role in its occurrence [3,8,11].…”