Orthodontic-surgical treatment of bilateral maxillary canine impaction

Abstract

A 13-year-old female patient reported with the chief complaint of irregular front teeth. She had a skeletal Class III and Angle's Class I malocclusion with hyperdivergent growth pattern and bilateral impaction of maxillary canines. Surgical exposure of the impacted teeth and orthodontic alignment was planned. The surgical exposure was done by a minimally invasive modified window technique. Orthodontic treatment of impacted canines without causing significant morbidity to the adjacent teeth and periodontium is a challenge. The bilaterally impacted maxillary canines were successfully aligned and leveled. The depth of the gingival sulcus and clinical crown heights of disimpacted teeth were normal post-treatment and after 1 year of retention.

Incidence of Impacted Canines in Maxillary Arch

“…Among 800 patients, 17 patients had impacted maxillary canines, out of which 10 of them were Male patients and 7 of them were female patients.On analysing the results it can be concluded that there is an increased incidence of maxillary canine impaction when compared to females.This is in contrary with the other study, which suggest the higher incidence of maxillary canine impaction in females,than in males.Maxillary canines erupt at an average age from 11-12 yrs, erupting earlier in females than in males (5) .Buccally placed canines are more common than palatally placed canines.Buccally and palatally placed impacted canines have different etiology,where buccally placed canines had sufficient place for eruption whereas palatally placed canines had insufficient place (5) .Almost every patient had unilateral impaction,except for one of the patients with bilateral impacted teeth.…”

“…The surgical techniques to expose the impacted teeth , include open eruption and closed eruption techniques (5) .A study has evaluated the application of extended nasolabial flap versus buccal fat pad graft in the surgical management of oral submucous fibrosis (20) .…”

“…Impacted tooth is the one that is prevented from erupting into the position due to lack of adequate spaces,malposition and other impediments.Maxillary canines corresponds the most common impacted tooth following third molars (1) .Dental anxiety and anxietyrelated avoidance of dental care creates significant problems for the patients and dental practitioners (2) The etiology of impacted maxillary canines is still unknownTheir occurrence is considerable and its frequency increases with other genetically associated dental anomalies (3) .Notwithstanding the opinions of some researchers in favour of an exclusively genetic etiology for its occurrence,there are many and various reasons for impacted canines (4) .The maxillary canines are one of the most important teeth in terms of aesthetic Corresponding Author: Dinesh Prabu, Senior Lecturer, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai. dineshprabum.sdc@saveetha.com Contact Number :9790798719 and function (5) .In dentistry, various treatment procedures are done to treat dental problems. (6) .Treatment of impacted maxillary canine is a common challenge faced by dental professionals in daily practice (7) .Alignment of impacted canines with minimal morbidity of adjacent teeth and periodontium is the main challenge being faced.…”